Case Manager, Reimbursement

Job Summary

Providing day-to-day case management oversight, the remote Case Manager, Reimbursement will ensure timely completion of prior authorizations, appeals, and patient eligibility assessments while serving as a primary resource 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 experience in pharmacy benefit management preferred
• Experience as a Medical Assistant, Social Worker, or Senior Reimbursement Specialist preferred
• Proficiency in Microsoft Office applications
• Knowledge of medical and claims processing terminology