Sr. Reimbursement Specialist - 4 Month Fixed Term
New
J
JobgetherBiotechnology / Pharmaceuticals
Fully remote work within the United States, Monday through Friday, 8:00 AM–5:00 PM ET or 9:00 AM–6:00 PM ETContractSenior
Salary not disclosed
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Job Details
- Experience
- 4–6 years
- Required Skills
- Microsoft OfficeCustomer service
Requirements
- High School Diploma, GED, or equivalent professional experience.
- 4–6 years of experience in insurance, biotechnology, pharmaceuticals, reimbursement, or customer service.
- Practical knowledge of reimbursement processes, third-party billing, medical coding, prior authorizations, appeals, and medical terminology.
- Strong computer skills, including proficiency with Microsoft Office applications.
- Excellent written and verbal communication skills.
- Strong customer service skills and the ability to interact professionally and empathetically with patients and their families.
- Excellent attention to detail and analytical skills for reviewing insurance information and patient case documentation.
- Ability to manage multiple priorities, monitor case progress, and meet deadlines in a fast-paced environment.
- Availability to work Monday through Friday on either an 8:00 AM–5:00 PM ET or 9:00 AM–6:00 PM ET schedule.
- Ability to commit to six weeks of virtual, cameras-on training with perfect attendance at the beginning of the contract.
Responsibilities
- Conduct benefit investigations and verify insurance coverage for patients and physician offices, submitting and obtaining prior authorizations and recertifications when required.
- Maintain accurate patient records and case data, monitoring outstanding items and ensuring files are complete and up to date.
- Coordinate with sales representatives, management teams, healthcare providers, and other stakeholders regarding case status, product orders, and alternative funding.
- Coordinate product orders, shipment arrangements, and therapy initiation with pharmacies and patients to help ensure timely treatment.
- Participate in call center activities, responding to inquiries from patients, insurance companies, physicians, sales representatives, pharmacies, and homecare agencies.
- Serve as a primary point of contact for assigned prescribers, providing consistent communication and case support.
- Identify and report events in accordance with applicable REMS requirements, including adverse events, product quality complaints, and potential risk events.
- Educate patients, prescribers, and other stakeholders on program requirements and facilitate appropriate referrals.
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