Reimbursement Case Manager

Job Summary

Working remotely, the full-time Reimbursement Case Manager will manage customer service and case management functions, acting as a patient advocate while coordinating access to therapies and assisting with reimbursement-related activities.

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, conducts follow-ups, and validates patient information for eligibility and enrollment in assistance programs
• Performs reimbursement activities such as benefit investigations, prior authorizations, and appeals while maintaining compliance with HIPAA regulations

Required qualifications

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