What You'll Do
Support patients and healthcare providers in securing access to prescribed treatments by managing the end-to-end reimbursement process. You'll assist with prior authorizations, appeals, and insurance benefits verification, ensuring timely therapy initiation.
Collaborate directly with insurance carriers, third-party administrators, and specialty pharmacies to resolve coverage denials and clarify payer requirements. Provide clear guidance on financial assistance options and help providers understand patient benefits.
Maintain thorough records of all case interactions, including communications with payers and outcomes, while adhering to federal, state, and organizational compliance standards. Share insights on reimbursement trends with internal teams to support strategic improvements.
Identify recurring obstacles in the reimbursement workflow and recommend process enhancements to increase efficiency and improve patient access. Stay current on evolving payer policies and regulatory changes to deliver accurate, up-to-date support.
Requirements
A bachelor’s degree from an accredited institution is required. Candidates must have at least three years of experience in reimbursement, patient access, or pharmaceutical account management. Knowledge of how medications are covered under commercial and government benefit designs is essential.
Familiarity with HIPAA and patient privacy regulations is expected, along with strong written and verbal communication abilities. Proficiency with Microsoft Office, virtual meeting tools, and CRM platforms is necessary. You must be able to work compliantly across all U.S. time zones as needed and complete all required training programs.
Preferred Qualifications
A degree in healthcare administration, business, or a related field is preferred. Prior experience in the pharmaceutical industry or direct coordination with specialty pharmacies will strengthen your application.
Benefits
- Medical, dental, and vision coverage
- Company-funded disability insurance
- 401K plan
- Generous paid time off
- Paid holidays
- Comprehensive benefits package
