San Diego, CA30+ days ago
Responsibilities Proactive Office Support Throughout FILSPARI Onboarding Process: * Access & Reimbursement Manager (ARM), serves as the key contact responsible for patient access and reimbursement in an assigned geography that provides appropriate support to providers and professional staff * Cultivate the highest level of expertise in the FILSPARI onboarding process, from Patient Start Form (PSF) submission through REMS enrollment to reimbursement * Walk offices through what to expect from the FILSPARI onboarding process, either when a new PSF comes in or when an opportunity for re-education is identified * Educate physicians and physician practices on the full FILSPARI onboarding process, including how to complete the PSF, how to enroll patients and physicians in REMS, requirements for prior authorization approvals, appeal approvals, and specific medical policy steps to obtain reimbursement * Closely monitor cases as they progress through the onboarding process Escalated Support for Specific Cases * Proactively identify and solve complex patient access issues by working across the Hub, HCP offices and communicating with field team. * Assist physicians and office staff when PSFs or REMS enrollment forms are submitted with information missing; coordinate with Hub and REMS Administrator partners to be able to clearly explain to the office what information is missing * Assist physicians and office staff in resolving access issues (prior authorization, appeals, denials, letters of medical necessity, REMS), and help ensure appropriate education to avoid future reimbursement hurd * Effectively partner with reimbursement stakeholders (specialty pharmacy, sales team, HCP office, REMS administrator, etc.) to communicate challenges, identify solutions, and ensure the patient is progressing through the reimbursement process * Understand specifics and support questions associated with PSF submission, REMS enrollment, payer policies (e.g., PAs process and denial, and appeals), patient reimbursement (e.g., Co-pay, PAP), reimbursement issues & opportunities (as needed).