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 therapies and providing support for reimbursement processes.

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, conducts follow-ups, and facilitates enrollment in patient assistance programs
• Performs reimbursement-related activities including benefit investigations, prior authorizations, and appeals

Required qualifications

• Minimum of 3 years of experience in a specialty pharmacy, medical insurance, or healthcare setting
• Bachelor's Degree preferred
• Extensive knowledge of HIPAA regulations and compliance
• Proficiency in MS Word and Excel
• Understanding of pharmacy and medical benefits, with knowledge of commercial and government payers preferred