Reimbursement Specialist - Healthcare jobs in Durham, NC

Reimbursement Specialist - Healthcare determines the extent to which patients' insurance covers their treatments. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. Being a Reimbursement Specialist - Healthcare ensures compliance with Federal and State regulations and company policies that govern Medicare and state payment systems. May assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation. Additionally, Reimbursement Specialist - Healthcare may require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. The Reimbursement Specialist - Healthcare gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Reimbursement Specialist - Healthcare typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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ViiV (GSK) Director, Learning & Development, Field Reimbursement (FRM)
  • ViiV Healthcare
  • Durham, NC FULL_TIME
  • ViiV Healthcare is an independent, global specialist HIV company dedicated to delivering innovative new options for the care and treatment of people living with HIV/AIDS. HIV presents a serious global challenge. At ViiV Healthcare we are using our commitment, expertise and passion to help meet this challenge by dedicating ourselves to delivering advances in treatment and care for people living with HIV.

    ViiV Healthcare was created in 2009 with an ambition of launching a "best in class" integrase inhibitor, maximizing value of existing HIV products and allowing acute company focus on developing initiatives, compounds and access that would advance the care and treatment of HIV.Since that time, the successful launches of 4 Dolutegravir-based products have increased internal and external stakeholder demand for Medical Affairs support to ensure appropriate use of and access to our products as well as to serve as an educational resource.

    In addition, there is consistent progression of research on ViiV Healthcare compounds to address data gaps that exist for Dolutegravir and our newer compounds, which includes advancing cabotegravir clinical development for both HIV treatment and prevention. The NA Medical Affairs team continues to play a significant role in ensuring capable sites are identified and selected, researchers are properly educated and informed, and studies progress in timely manner.

    Additionally, HIV therapy is now being actively managed by many players and this has elevated the need to provide HIV clinical and research information to formulary decision makers and payers groups, increasing demand for Medical Affairs partnership.

    There is a critical need now to enhance the medical and scientific leadership capability to effectively and credibly exchange high quality medical and scientific information about ViiV products and the disease area with our customers. Without this, we will not be able to deliver on our promises to patients or to our shareholders and become industry-leading.

    As the ViiV Healthcare Director, Learning & Development, Field Reimbursement (FRM), you will lead training, including the development and execution of the training plan, for the FRM team in the US HIV market. This includes developing and leading an onboarding program for new FRMs/FRDs, developing and leading sustainment training for the existing FRM/FRD team, and consulting with brand trainers on implementation training processes as needed. This role represents an incredible opportunity to help ViiV Healthcare further reduce the impact of HIV on individuals and communities. Please note that this role is based out of ViiV's US Headquarters in Durham, NC & is eligible for a full relocation package.

    This role will provide YOU the opportunity to lead key activities to progress YOUR career, these responsibilities include some of the following...

    • Develop and embed robust, industry-leading field reimbursement training curricula to support current promoted brands.
    • Partner across FRM team to develop and deliver training consistent with brand strategy that prepares the reimbursement team to deliver on appropriate needs of their customers and patients
    • Understand the intricacies of the customer experiences within different accounts to infuse field reimbursement training with healthcare provider needs and insights
    • Design customized training that connects reimbursement behaviors with application of knowledge and skills to optimize insights and maximize effectiveness of reimbursement team
    • Influence, connect, and lead across a matrix of stakeholders to ensure that the training is aligned, optimized, and reflects appropriate ways of working
    • Create training materials from initiation to approval, following the appropriate approval process
    • Optimize training across appropriate platforms (both virtual and face to face) utilizing adult learning principles
    • Manage external partner relationships
    • Maintain appropriate and accurate records of training

    Why you?Basic Qualifications:

    We are looking for professionals with these required skills to achieve our goals:

    • Bachelor's Degree
    • Experience in Field Reimbursement within the Pharmaceutical Industry
    • Experience in Specialty Pharmaceutical account management principles and execution
    • Working knowledge of specialty pharmaceutical medicines, including long-acting injections

    Preferred Qualifications:

    If you have the following characteristics, it would be a plus:

    • Training Experience
    • Demonstrated knowledge of adult learning principles and how best to design training plans to optimize learning, retention, and application
    • Leadership Experience
    • MBA or graduate degree
    • Experience in developing training plans to pull through reimbursement skills and concepts to maximize organizational and representative impact
    • Proven experience and acumen in coaching and motivating others
    • Experience developing and delivering training plans for injectable specialty products in the pharmaceutical industry
    • Proven success actively participating and leading in matrix team environments
    • Working knowledge of HIV disease state and products
    • High level demonstration of leadership behaviors, excellent strategic thinking and interpersonal skills
    • Proven formal and informal communication skills, with the ability to communicate and present effectively to large groups and leaders

    #LI-ViiiV

    #LI-GSK

    *This is a job description to aide in the job posting, but does not include all job evaluation details.

    Please visit to learn more about the comprehensive benefits program ViiV offers US employees. All ViiV employees receive the same benefits options and plans as GSK employee.

    Why Us?

    At ViiV Healthcare, we will not rest until we leave no person living with HIV behind. Until the 39 million people living with HIV is down to zero, we will continue searching for new ways to limit the impact of HIV.

    We are the only pharmaceutical company solely focused on combating, preventing, and ultimately eradicating HIV and AIDS. At ViiV Healthcare, we do things differently. Born out of a partnership between and in 2009, with joining in 2012, we are determined to help end the HIV epidemic. We are guided by our mission to leave no person living with HIV behind and it is this mission that unites our employees located across the globe. We combine expertise in research, manufacturing, policy and more to push the boundaries of what people think is possible in HIV treatment and care. As a result of our connection with GSK, we are able to draw on their proud history and resources. This means that you would receive all the employee benefits offered by GSK.

    Living our mission of leaving no person living with HIV behind means keeping inclusion and diversity at the heart of everything we do - from our breakthrough innovation, to our diverse portfolio of medicines as well as the work we do to partner with HIV communities. Having a diverse team and a truly inclusive culture where we're all able to be ourselves and feel like we belong will make us an even stronger team, better able to perform as a business and deliver on our mission to leave no person living with HIV behind.

    If you require an accommodation or other assistance to apply for a job at ViiV, please contact the ViiV Service Centre at 1-877-694-7547 (US Toll Free) or 1 801 567 5155 (outside US).

    ViiV is an Equal Opportunity Employer and, in the US, we adhere to Affirmative Action principles. This ensures that all qualified applicants will receive equal consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, marital status, sexual orientation, gender identity/expression, age, disability, genetic information, military service, covered/protected veteran status or any other federal, state or local protected class.

    Important notice to Employment businesses/ Agencies

    ViiV does not accept referrals from employment businesses and/or employment agencies in respect of the vacancies posted on this site. All employment businesses/agencies are required to contact ViiV's commercial and general procurement/human resources department to obtain prior written authorization before referring any candidates to ViiV. The obtaining of prior written authorization is a condition precedent to any agreement (verbal or written) between the employment business/ agency and ViiV. In the absence of such written authorization being obtained any actions undertaken by the employment business/agency shall be deemed to have been performed without the consent or contractual agreement of ViiV. ViiV shall therefore not be liable for any fees arising from such actions or any fees arising from any referrals by employment businesses/agencies in respect of the vacancies posted on this site.

    Please note that if you are a US Licensed Healthcare Professional or Healthcare Professional as defined by the laws of the state issuing your license, ViiV may be required to capture and report expenses ViiV incurs, on your behalf, in the event you are afforded an interview for employment. This capture of applicable transfers of value is necessary to ensure ViiV's compliance to all federal and state US Transparency requirements. For more information, please visit ViiV's Transparency Reporting site.

     

  • 1 Month Ago

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Reimbursement Specialist - HBC Vendor Support - Remote
  • Duke Health
  • Durham, NC FULL_TIME
  • At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discov...
  • 1 Month Ago

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Healthcare Billing Specialist
  • Triangle Visions Optometry
  • Cary, NC FULL_TIME
  • Are you a detail-oriented communicator with a passion for healthcare? If so, consider becoming a vital member of the Triangle Visions team in our Cary, NC location as a Healthcare Billing Specialist. ...
  • Just Posted

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Nurse Practitioner
  • Specialist Office
  • Wilson, NC FULL_TIME
  • Nurse Practitioner or Physician Assistant – OncologyWilson, North CarolinaMUST:Registered Nurse Practitioner or Physician AssistantMust have 2-3 years of NP/PA experienceOncology experience requiredGr...
  • 15 Days Ago

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Lawn Specialist
  • TruGreen - Lawn Specialist - Cary, NC
  • Franklinton, NC FULL_TIME
  • TruGreen is Hiring Residential Lawn SpecialistsImmediate Openings in Cary, NCAt TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. A career with TruGreen...
  • 2 Days Ago

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Strategic Account Specialist, Healthcare - Spectrum Enterprise
  • SPECTRUM
  • Cary, NC FULL_TIME
  • Location: Cary, North Carolina Date Posted: Date posted 04/17/2024 Areas of interest: Business Development, Enterprise Sales, Sales Requisition Number: 2024-32278 Business unit: Spectrum Enterprise SC...
  • 6 Days Ago

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0 Reimbursement Specialist - Healthcare jobs found in Durham, NC area

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CRL Operations & Finance Specialist
  • CRL
  • Durham, NC
  • Who We Are: The Center for Responsible Lending (CRL) is a nonprofit, non-partisan organization working to ensure a fair,...
  • 4/26/2024 12:00:00 AM

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Associate Director, Access & Reimbursement - Oncology - REMOTE
  • Proclinical Staffing
  • Raleigh, NC
  • Associate Director, Access & Reimbursement (Oncology) - Permanent - Remote Proclinical Staffing is seeking an Associate ...
  • 4/25/2024 12:00:00 AM

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National Director, Access and Reimbursement
  • The Judge Group
  • Raleigh, NC
  • *** Position can be based anywhere in US *** Who We Are: Harvesting Hope with a Growing Family At Merz Therapeutics, we ...
  • 4/25/2024 12:00:00 AM

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Commercial Sales Manager
  • AutoZone, Inc.
  • Durham, NC
  • The Commercial Sales Manager is responsible for driving the commercial sales within their AutoZone location. The CSM dev...
  • 4/25/2024 12:00:00 AM

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Nurse Practitioner - Advanced Practice Provider
  • Oak Street Health Inc.
  • Durham, NC
  • Title: Nurse Practitioner - Advanced Practice Provider Schedule: Full-Time, Monday through Friday, 8:00 AM - 5:00 PM Loc...
  • 4/25/2024 12:00:00 AM

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Medical Records Coder II-Commitment Bonus - No Experience Required
  • Duke University
  • Durham, NC
  • At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones,...
  • 4/24/2024 12:00:00 AM

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LTSS Care Manager
  • Centene Corporation
  • Durham, NC
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Managem...
  • 4/24/2024 12:00:00 AM

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Registered Nurse, Med/Surg Float Pool RN
  • Duke Health
  • Durham, NC
  • Work Schedule Full Time Day or Night Shifts: 3, 12-hour shifts with varying weekends Weekend option for Experienced RNs ...
  • 4/24/2024 12:00:00 AM

Durham is a city in and the county seat of Durham County in the U.S. state of North Carolina. The U.S. Census Bureau estimated the city's population to be 251,893 as of July 1, 2014, making it the 4th-most populous city in North Carolina, and the 78th-most populous city in the United States. Durham is the core of the four-county Durham-Chapel Hill Metropolitan Area, which has a population of 542,710 as of U.S. Census 2014 Population Estimates. The US Office of Management and Budget also includes Durham as a part of the Raleigh-Durham-Chapel Hill Combined Statistical Area, which has a populatio...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$43,606 to $52,987
Durham, North Carolina area prices
were up 1.5% from a year ago

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