Senior Case Manager, Reimbursement

Job Summary

To support a growing pharmaceutical support practice, the full-time remote Senior Case Manager, Reimbursement will manage a caseload, ensuring timely completion of prior authorizations, reauthorizations, and appeals while acting as a primary resource for patients and healthcare providers.

Key responsibilities

• Provide day-to-day oversight and coordination of caseload to ensure timely completion of all case elements
• Act as the primary point of contact for prior authorization and appeal processing communications with patients and external stakeholders
• Serve as a patient advocate, assisting patients in navigating the reimbursement process and coordinating additional patient access services

Required qualifications

• Bachelor's degree or six years of relevant working experience
• Five or more years of relevant experience in pharmacy benefit management, specialty pharmacy, or patient support/access services preferred
• Three or more years of relevant experience in pharmacy and/or medical benefit verifications, prior authorization, and/or appeals required
• Experience as a Medical Assistant, Social Worker, or Senior Reimbursement Specialist preferred
• Proficient in Microsoft Office applications and knowledgeable in medical and claims processing terminology