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.

• Handle the submission and acquisition of prior authorizations as mandated by payers.

• Secure recertification for cases that necessitate extended treatment or coverage.

• Precisely input and manage data within client databases and patient records.

• Track outstanding tasks and ensure all files are complete.

• Engage in conference calls regarding case updates, medication orders, and alternative funding options.

• Organize product orders, shipments, and therapy initiation in collaboration with pharmacies and patients.

• Take part in call center operations and manage incoming calls effectively.

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

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

• Identify and report events as stipulated by REMS requirements.

• Detect adverse events, product quality complaints, and potential risk events, and relay information for manufacturer documentation.

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

• Assist with referrals.

• Uphold housekeeping standards, quality and production benchmarks, and adherence to safety and environmental regulations.

⛳️ Requirements

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

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

• Experience in health insurance claims or patient accounting is advantageous.

• Proficiency in MS Office applications, with experience in databases being a plus.

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

• Capability to manage multiple tasks effectively and meet deadlines.

• Detail-oriented with strong analytical skills.

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

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

• Availability to work M–F from 8 AM to 5 PM ET or M–F from 9 AM to 6 PM ET.

🏝️ Benefits

• Remote work opportunities available.

• Competitive salary packages.

• Opportunities for career advancement.

• 401K plan with company matching.*

• Tuition reimbursement program.

• Flexible work environment.

• 20 days of paid time off (PTO).

• Paid holidays.

• Employee assistance programs.

• Comprehensive medical, dental, and vision coverage.

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

• Telemedicine services (virtual doctor appointments).

• Wellness programs.

• Adoption assistance.

• Short-term disability coverage.

• Long-term disability coverage.

• Life insurance options.

• Discount programs.

• Equipment provided for remote work.