Case Manager, Reimbursement

Job Summary

Providing day-to-day case management oversight, the remote Case Manager, Reimbursement will coordinate an assigned caseload, ensuring timely completion of prior authorizations, appeals, and accurate documentation for patients and healthcare providers.

Key responsibilities

• Oversee and coordinate caseload to ensure timely completion of all case elements and tasks
• Act as the primary point of contact for prior authorization and appeal processing communications
• Perform quality checks on cases and report trends to leadership

Required qualifications

• Bachelor's degree or six years of relevant working experience
• Two or more years of relevant experience in pharmacy benefit management preferred
• Experience as a Medical Assistant, Social Worker, or Senior Reimbursement Specialist preferred
• Proficient in Microsoft Office applications
• Knowledge of medical and claims processing terminology