Reimbursement Business Advisor, Botox - Kansas City, KS
Job Description
The Reimbursement Business Advisor (RBA) shares expertise and educates on Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX® Therapeutics.
The RBA clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes. The RBA may interact with healthcare providers, administrative staff, revenue cycle management, and institutional leadership.
After the patient has been identified by an ABS provider, the RBA offers approved tools and standardization methods to provide reimbursement and technical knowledge to gain patient access while reducing access challenges.
Educate on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscape
Leverages advance problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved care
Uncover the root cause to access issues impeding or delaying proper treatment
Monitor and provide updates on both Region and National Payers. Examples include changes or barriers in medical policy, Prior Authorization requirements, or product acquisition. Apply compliant methods to exchange critical information
Work collaboratively and function as a liaison for information between various internal stakeholders such as: Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups.
Provide customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders (Market Access, Center of Excellence, Sales, Marketing, Trade, Specialty Pharmacy, Senior Leadership)
Educate accounts on need-based tools to support patient access. Examples include HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiatives
Proficient in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practices
Establish and maintain respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territory
Demonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different priorities
Capable of influencing across functions to gain consensus on agreed upon patient solutions
Ability to professionally deliver crucial conversations that may contain less than desirable information or facts
Proactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environment
Share customer challenges and suggest potential solutions to address obstacles
Demonstrate effective planning, prioritization, follow up, and anticipates problems
The employee conducts all work activities in compliance with all Abbvie internal requirements and with all applicable regulatory requirements
The Reimbursement Business Advisor (RBA) shares expertise and educates on Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX® Therapeutics.
The RBA clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes. The RBA may interact with healthcare providers, administrative staff, revenue cycle management, and institutional leadership.
After the patient has been identified by an ABS provider, the RBA offers approved tools and standardization methods to provide reimbursement and technical knowledge to gain patient access while reducing access challenges.
Educate on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscape
Leverages advance problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved care
Uncover the root cause to access issues impeding or delaying proper treatment
Monitor and provide updates on both Region and National Payers. Examples include changes or barriers in medical policy, Prior Authorization requirements, or product acquisition. Apply compliant methods to exchange critical information
Work collaboratively and function as a liaison for information between various internal stakeholders such as: Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups.
Provide customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders (Market Access, Center of Excellence, Sales, Marketing, Trade, Specialty Pharmacy, Senior Leadership)
Educate accounts on need-based tools to support patient access. Examples include HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiatives
Proficient in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practices
Establish and maintain respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territory
Demonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different priorities
Capable of influencing across functions to gain consensus on agreed upon patient solutions
Ability to professionally deliver crucial conversations that may contain less than desirable information or facts
Proactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environment
Share customer challenges and suggest potential solutions to address obstacles
Demonstrate effective planning, prioritization, follow up, and anticipates problems
The employee conducts all work activities in compliance with all Abbvie internal requirements and with all applicable regulatory requirements
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