Caseworker

This is a fully remote position, open to applicants in Canada.

📋 Description

• Oversee all elements necessary to secure prescription drug coverage for patients.

• Collaborate with insurance companies, medical offices, and healthcare providers to enhance reimbursement solutions.

• Manage documents, submissions, and associated paperwork with insurance entities and public/federal funding programs.

• Execute Financial Means Tests to optimize patients' prescription drug coverage.

• Facilitate pharmacy operations once funding has been secured.

• Develop a comprehensive understanding of public, private, and federal funding systems.

• Report any Adverse Events to the designated units/departments.

• Handle patient cases and ensure timely and accurate processing of coverage-related inquiries.

• Organize benefits documentation, case updates, follow-up tasks, and reimbursement communications.

• Address routine reimbursement challenges, documentation deficiencies, and workflow anomalies.

• Keep precise case records, reimbursement documentation, and system updates.

• Track reimbursement patterns, recurring challenges, and escalation signals.

• Collaborate with internal and external parties to clarify reimbursement requirements and facilitate case resolution.

• Contribute to enhancements in processes, updates to workflows, and operational readiness initiatives.

⛳️ Requirements

• High School Diploma/GED or equivalent experience is mandatory.

• A minimum of 2 years of experience in reimbursement support, patient services, customer operations, healthcare support services, case coordination, claims support, or a similar field is required.

• Certification in reimbursement support, patient access, customer support, service management, customer relationship management systems, or process improvement is preferred.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Backup dependent care.

• Adoption assistance.

• Infertility coverage.

• Family building support.

• Behavioral health solutions.

• Paid parental leave.

• Paid caregiver leave.

• Training programs.

• Professional development resources.

• Mentorship programs.

• Employee resource groups.

• Volunteer opportunities.