Reimbursement Case Manager

Job Summary

Working remotely, the full-time Reimbursement Case Manager will manage patient and provider inquiries, advocate for patient access to therapies, and perform reimbursement-related activities while ensuring compliance with HIPAA regulations.

Key responsibilities:

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

Required qualifications:

• Minimum of 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
• Familiarity with pharmacy and medical benefits, as well as commercial and government payers
• Proficiency in MS Word and Excel