Senior Reimbursement Specialist – 4 Month Fixed Term

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

📋 Description

• Perform benefit investigations and confirm insurance benefits for patients and healthcare providers.

• Submit requests and secure prior authorizations as mandated by insurance payers.

• Acquire recertification for cases that necessitate prolonged treatment or coverage.

• Accurately input and manage data in the client database and patient records.

• Track outstanding items and ensure that files are comprehensive.

• Engage in conference calls with Client Sales Representatives, client management, and healthcare providers.

• Organize product orders, manage product shipments, and coordinate therapy initiation with pharmacies and patients.

• Participate in call center operations and manage incoming calls effectively.

• Address inquiries from patients, insurance companies, healthcare providers, sales representatives, pharmacies, and homecare agencies.

• Act as a primary contact for designated prescribers when necessary.

• Identify and report events as required by REMS regulations.

• Recognize adverse events, product quality complaints, and potential risk situations, forwarding them for manufacturer reporting.

• Provide education to patients, prescribers, and others regarding program requirements.

• Facilitate the referral process.

• Uphold housekeeping, quality, production, safety, and environmental standards.

⛳️ Requirements

• High School Diploma/GED or equivalent relevant experience.

• 4–6 years of experience in the insurance, biotechnology, or pharmaceutical sectors; customer service and/or reimbursement preferred.

• Experience in health insurance claims or patient accounting is a plus.

• Proficiency in MS Office applications; database experience is an added advantage.

• Exceptional written and verbal communication skills, with a proven ability to interact with individuals at all levels.

• Capability to handle multiple priorities and adhere to deadlines.

• Detail-oriented with strong analytical abilities.

• Familiarity with third-party billing, coding, medical terminology, prior authorizations, and appeals is preferred.

• Perfect attendance is required during 6 weeks of virtual training with cameras on.

• Availability from M-F 8AM-5PM ET or M-F 9AM-6PM ET.

🏝️ Benefits

• Remote work opportunities.

• Competitive salary packages.

• Opportunities for career advancement and promotion.

• 401K plan with company matching.*

• Tuition reimbursement programs.

• Flexible working environment.

• 20 days of Paid Time Off (PTO).

• Paid holidays.

• Employee assistance programs.

• Comprehensive medical, dental, and vision coverage.

• Health Savings Account (HSA) and Flexible Spending Account (FSA).

• Telemedicine services (virtual doctor appointments).

• Wellness program initiatives.

• Adoption assistance options.

• Short-term and long-term disability insurance.

• Life insurance coverage.

• Employee discount programs.

• Necessary equipment provided.