Senior Reimbursement Specialist – Fixed-Term

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

📋 Description

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

• Submit and secure prior authorizations as mandated by payers.

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

• Accurately input and maintain data within the client database and patient records.

• Monitor unresolved items on client case files and ensure their completeness.

• Engage in conference calls with Client Sales Representatives, client management, and healthcare providers concerning case status, medication orders, and alternative funding options.

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

• Take part in call center operations, including triaging and responding to incoming inquiries.

• Act as a single point of contact for assigned prescribers when necessary.

• Identify and report occurrences as mandated by REMS requirements.

• Recognize adverse events, product quality complaints, and potential risk occurrences, and relay information for manufacturer reporting.

• Educate patients, prescribers, and other stakeholders on program requirements.

• Facilitate referrals.

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

• Deliver customer service and collaborate with patients, families, national payers, home care providers, and medical offices to expedite patient treatment and enhance reimbursement.

⛳️ Requirements

• High School Diploma/GED or equivalent experience.

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

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

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

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

• Capability to manage multiple priorities and adhere to deadlines.

• Detail-oriented with strong analytical skills.

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

• Candidates must possess a HIPAA-compliant workspace and reliable high-speed internet access.

• Availability required Monday through Friday, 9:00 AM–6:00 PM EST; shift flexibility is not available.

• Scheduled time off cannot be accommodated during the contract period.

🏝️ Benefits

• Remote opportunities.

• Competitive salaries.

• Opportunities for career advancement.

• 401K with company matching.

• Tuition reimbursement.

• Flexible working environment.

• 20 days of Paid Time Off (PTO).

• Paid Holidays.

• Employee assistance programs.

• Medical, Dental, and Vision coverage.

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

• Telemedicine services (virtual doctor appointments).

• Wellness program.

• Adoption assistance.

• Short and long-term disability insurance.

• Life insurance coverage.

• Discount programs.

• UBC will supply all necessary equipment, including desktop hardware and software.