Reimbursement Specialist Supervisor

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

📋 Description

• Oversee, coordinate, and manage the workflow of Reimbursement Specialists across various clinics.

• Offer direct line supervision for Reimbursement Specialists, encompassing performance evaluations, disciplinary actions, attendance monitoring, coordination of staff activities, and other necessary tasks.

• Conduct the hiring, interviewing, onboarding, and training processes for new employees.

• Track team productivity and adherence to turnaround times, providing constructive feedback and coaching as necessary.

• Lead the training and onboarding of new Reimbursement Specialists.

• Assess complex or escalated prior authorizations and appeals, ensuring proper documentation and compliance with insurance and regulatory standards.

• Collaborate with healthcare providers, nursing personnel, and the Patient Assistance Program (PAP) team to guarantee patients have timely access to medications.

• Recognize opportunities for process enhancements to improve team efficiency and patient care results.

• Prepare and analyze reports on team performance, Patient Assistance (PA) approvals/denials, and workload metrics.

• Ensure adherence to departmental and health system policies as well as regulatory requirements.

• Engage in special projects and cross-functional initiatives as required.

⛳️ Requirements

• High School Diploma or equivalent qualification.

• Current certification from the Pharmacy Technician Certification Board (PTCB).

• Current licensure from the Virginia State Board of Pharmacy.

• At least three (3) years of experience as a Reimbursement Specialist or in a similar role.

• Prior experience in supervising or mentoring staff.

• Strong understanding of PAPs, prior authorizations, and insurance benefit investigations.

• Proficient in EMR systems and Microsoft Office applications.

🏝️ Benefits

• Health insurance coverage.

• Retirement plan options.

• Paid time off benefits.

• Flexible work arrangements available.

• Opportunities for professional development.