Matthew Barnhart
Philadelphia,PA
Summary
A detail-oriented and self-motivated patient access and reimbursement specialist passionate about patients and helping them gain access to life-changing therapies. Expertise in specialty medications, local and national payer landscapes, and extensive experience with specialty providers in a wide range of therapeutic areas. Ability to lead projects and develop strong teams through empathy and compassion.
Overview
7
7
years of professional experience
Work History
Field Reimbursement Manager - Oncology
Johnson & Johnson Innovative Medicine
05.2024 - Current
- Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, etc.) for core and launch products.
- Collaborate with field support team members such as sales representatives and key account managers and serve as reimbursement expert for the local team
- Act with a sense of urgency to address critical access and affordability issues for patients
- Conduct field-based reimbursement and access support, education and creative problem-solving aligned to FRM Rules of Engagement
- Manage territory logistics, routing, and account business planning
- Maintain and grow knowledge of national, regional, local, and account market dynamics including coverage and coding requirements
- Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS. Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial).
- Execute business in accordance with the highest ethical, legal, and compliance standards, including timely and successful completion of all required training
Field Reimbursement Specialist
Cencora - Johnson & Johnson Innovative Medicine
07.2022 - Current
- Educate provider office staff and practice managers on logistics needed to support client products, Stelara, Remicade, and Simponi, including infrastructure needed to support in-office administration including buy and bill and monitoring of product, and important coverage and payer policy changes within assigned territories
- Educate provider office staff with understanding the payers' coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes
- Probe to understand office processes and ability to discern root causes of access or reimbursement issues
- Deliver interactive educational presentations at various provider sites of service
- Provide information on relevant reimbursement topics related to our client's products based on client's approval.
Lead Prior Authorization Technician
Penn Medicine
07.2017 - 07.2022
- Perform detailed benefit investigations, prior authorizations, and appeals for several therapeutic areas such as Neuroscience, Immunology, Oncology, and Cardiology, including specialty medications such as Kesimpta, Ocrevus, Botox, Stelara, Repatha, Neupogen, and Neulasta
- Assist practice managers and office staff with the buy and bill process to ensure proper reimbursement is established by verifying the correct IDC-10 code, NDC, CPT code, HCPCS, and J-code
- Facilitate the search for grants and foundations to assist with patients' out-of-pocket costs for specialty medications
- Communicate with third parties, such as HUBs to resolve patient access-related matters
- Compile, cleansed, and analyzed data used for new initiatives and monthly reporting
- Manage several projects for new departmental initiatives, such as new hire training programs.
Education
Bachelor of Science - Business Administration -
Southern New Hampshire University
Philadelphia, PA05.2022
Associate of Arts - Business Administration -
Community College of Philadelphia
Philadelphia, PA05.2015
Skills
- Medicare, Medicaid, & Commercial Benefits
- HCPCS & ICD-10 coding
- Expert in Microsoft Office, with a focus on Excel
- Project management
- Problem-solving & analytical
- Communication & collaboration
Timeline
Field Reimbursement Manager - Oncology
Johnson & Johnson Innovative Medicine
05.2024 - Current
Field Reimbursement Specialist
Cencora - Johnson & Johnson Innovative Medicine
07.2022 - Current
Lead Prior Authorization Technician
Penn Medicine
07.2017 - 07.2022
Bachelor of Science - Business Administration -
Southern New Hampshire University
Associate of Arts - Business Administration -
Community College of Philadelphia
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