Senior Reimbursement Specialist

Job Summary

To support a copay program, the full-time Senior Reimbursement Specialist will manage patient and pharmacy interactions, resolve complex escalations, and ensure accurate updates to protected health information (PHI) while coordinating with internal teams and clients.

Key responsibilities:

• Manage escalations related to manufacturer copay programs, ensuring timely resolution and closure
• Conduct benefit investigations and verify insurance benefits while submitting prior authorizations as required
• Participate in call center activities, responding to incoming calls from various stakeholders and serving as a point of contact for prescribers

Required qualifications:

• High School Diploma/GED or equivalent experience
• 4 - 6 years of experience in insurance, biotechnology, or pharmaceutical industries, with a focus on customer service and reimbursement
• Proficiency in MS Office applications; database experience is a plus
• Knowledge of third-party billing, coding, medical terminology, prior authorizations, and appeals preferred
• Detail-oriented with strong analytical skills and the ability to manage multiple priorities