Sr. Reimbursement Specialist
New
U
UBCPharmaceutical Support
United States, M-F 8AM-5PM ET or M-F 9AM-6PM ETContractSenior
Salary not disclosed
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Job Details
- Experience
- 4 – 6 years
- Required Skills
- MS OfficeCustomer serviceData entry
Requirements
- High School Diploma/GED or equivalent experience.
- 4 – 6 years of experience in the insurance, biotechnology, or pharmaceutical industries.
- Experience in customer service, reimbursement, health insurance claims, or patient accounting.
- Computer proficiency in MS Office applications.
- Experience with database systems.
- Knowledge of third-party billing, coding, and medical terminology.
- Understanding of prior authorizations and appeals processes.
- Ability to manage multiple priorities and meet deadlines.
- Excellent written and verbal communication skills.
- Detail-oriented with strong analytical skills.
- Ability to commit to 6 weeks of mandatory virtual cameras-on training with perfect attendance.
Responsibilities
- Conduct benefit investigations, verify insurance benefits, and submit prior authorizations.
- Obtain recertification for cases requiring extended treatment or coverage.
- Accurately enter and maintain data in client databases and patient files.
- Participate in conference calls with client sales representatives, management, and physician offices.
- Coordinate product orders, shipment, and therapy initiation with pharmacies and patients.
- Triage and respond to incoming calls from patients, insurance companies, and medical providers.
- Identify and report adverse events, product quality complaints, and potential risk events per REMS requirements.
- Educate patients and prescribers regarding program requirements and facilitate referrals.
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