Field Reimbursement Manager, Retina

Job not on LinkedIn

🔥 14 hours ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $200k - $230k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 6%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Thea Pharma US

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2019

💊 Pharmaceuticals

🏥 Healthcare

Pharmaceuticals • Healthcare

Thea Pharma US is the United States subsidiary of Laboratoires Théa and an independent pharmaceutical company that commercializes ophthalmic products. Established in 2019, Thea Pharma Inc. focuses on eye care—particularly treatments for the anterior segment and ocular surface conditions—and serves doctors and other healthcare providers with products (including preservative-free formulations) intended for the U. S. market.

📋 Description

• Conduct pre-launch and immediate post-launch billing and coding workshops for high-volume retina practices • Educate practices on submitting claims using new permanent J-Code HCPCS codes and support the transition once ASP is established • Monitor initial claim submissions and troubleshoot payer rejections or clearinghouse formatting errors • Provide reimbursement, coverage, and access expertise to retina practices, ASCs, and hospital outpatient departments • Educate clinic staff, billing personnel, and practice managers on payer policies, prior authorization, claims submission, and J-code, CPT, and ICD-10 coding • Analyze and help resolve denied claims, underpayments, and complex appeals with compliant guidance • Guide practices on buy-and-bill operations, specialty pharmacy fulfillment, inventory management, and co-pay or patient assistance programs • Track local commercial and Managed Medicaid policy determinations and relay market updates to internal launch teams • Train clinic staff to use the Patient Support Program Hub for benefits verification and prior authorization support • Collaborate with Field Sales, Key Account Managers, Patient Support Services, Compliance, Finance, Distribution, and Training • Prepare accounts for launch, mitigate billing uncertainties, accelerate time-to-treatment, and build confidence in reimbursement processes • Report to the Director of Retina Field Reimbursement

🎯 Requirements

• 2+ years of direct experience executing buy-and-bill product launches in the specialty biologic or pipeline space • Prior experience in Ophthalmology/Retina highly preferred • Deep understanding of Medicare Part B, ASP models, Medicare Part D, commercial insurance, Medicaid, and specialized Hub reimbursement services • Ability to navigate a fast-paced product launch environment with evolving payer policies • Exceptional presentation skills and ability to explain complex financial/billing rules simply • Strong problem-solving skills for resolving rejected claims • Strict adherence to HIPAA, OIG guidance, and company compliance policies • Demonstrated success partnering in a matrixed environment • Extensive proficiency with Microsoft Office: Word, Excel, PowerPoint, Teams, and Outlook • Proficiency with CRM platforms • Approximately 50% travel, including overnight travel • Bachelor's degree required • 6+ years of experience in the pharmaceutical/biotech industry, specifically in medical reimbursement, patient access, or field reimbursement • 6+ years of experience supporting buy-and-bill products in ophthalmology, rare disease, or specialty pharmaceuticals preferred • Advanced degree or coding certification such as CPC, CHC, or PACs is a plus

🏖️ Benefits

• Employer-paid medical, dental, and vision insurance • Paid time off (PTO) • Life and disability insurance • Paid parental leave • Competitive 401(k) company match • Flexible and entrepreneurial work environment • Inclusive culture • Opportunity to shape the future of the company