North Carolina Licensed Case Manager

Job Summary

As a patient advocate, the remote Reimbursement Case Manager will manage patient eligibility, provide inbound and outbound phone support to patients and healthcare providers, and coordinate access to specialty pharmaceuticals while ensuring a positive patient experience.

Key responsibilities

• Oversee and coordinate caseload to ensure timely completion of case elements and tasks
• Act as the single point of contact for prior authorization and appeal processing communications
• Assess patient benefits and refer patients to special programs/services as needed

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
• Proficiency in Microsoft Office applications
• Knowledge of medical and claims processing terminology