Reimbursement Case Manager

Job Summary

Working remotely, the full-time Reimbursement Case Manager will manage customer service and case management for patients, healthcare providers, and pharmacies, ensuring access to specialty therapy treatments while maintaining compliance with HIPAA regulations.

Key responsibilities

• Acts as a single point of contact for patients and providers, advocating for their needs and enhancing their experience
• Coordinates access to therapies and manages case loads, including eligibility determination and patient enrollment activities
• Performs reimbursement-related activities such as benefit investigations, prior authorizations, and appeals while providing exceptional customer service

Required qualifications

• 3+ years of experience in a specialty pharmacy, medical insurance, or healthcare setting preferred
• Bachelor's Degree preferred
• Extensive knowledge of HIPAA regulations and reimbursement processes
• Proficiency in MS Word and Excel
• Ability to work independently and as part of a team, demonstrating strong interpersonal skills