Case Manager, Reimbursement

Job Summary

Providing day-to-day case management oversight, the remote Case Manager, Reimbursement will coordinate assigned caseloads, ensure timely prior authorizations and appeals, and serve as the 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 contact for prior authorization and appeal processing communications with stakeholders
• Assess patient eligibility for additional services and perform quality checks on cases

Required qualifications

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