Reimbursement Specialist, Bilingual

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

📋 Description

• Comprehend Insulet insurance contracts, channeling processes, and requirements for eligible products.

• Facilitate reimbursement by reaching out to payors, confirming insurance benefits, and following medical guidelines.

• Submit prior authorization requests to secure approval and payment for Insulet products during the claims process.

• Calculate and record cost-share amounts for customers who speak English and French.

• Collaborate with Case Management, Omnipod Sales, Billing, and other commercial teams regarding customer order updates.

• Log interactions and calls in the customer database.

• Ensure compliance with HIPAA and other regulatory standards.

• Offer feedback and recommendations for ongoing process enhancements.

• Perform additional responsibilities as required.

• Assist patients and customers in navigating insurance, reimbursement, and prior authorization procedures.

• Act as a resource for patients, healthcare providers, insurance payers, and internal teams.

⛳️ Requirements

• Associate's Degree.

• Strong proficiency in both English and French is highly preferred.

• Bachelor's Degree is preferred.

• 2-4 years of experience in a medical device, pharmaceutical, healthcare, or consumer product-related field is preferred.

• Familiarity with and knowledge of the managed care industry is preferred.

• Understanding of and experience in supporting patients with diabetes is preferred.

• Experience in reimbursement or working with private or public payers in Canada.

• Familiarity with Salesforce or another CRM system is preferred.

• Willingness to work overtime to achieve business objectives is required.

• Competence in oral and written communication in both English and French.

• Skills in problem-solving, collaboration, accountability, self-management, prioritization, and multitasking.

• Proficiency in MS Office applications and CRM systems.

• Ability to work in a standard office setting, involving both sitting and standing.

• Manual dexterity for operating a computer keyboard.

• Some lightweight lifting may be necessary.

🏝️ Benefits

• 100% remote working options; employees may work from home or virtually full-time.

• Hybrid on-site/virtual work arrangements can be selected if desired.

• Reasonable accommodations are available for individuals with disabilities.

• Opportunity to utilize bilingual language skills while developing expertise in reimbursement, managed care, and medical devices.