Amplity is seeking a Virtual Remote Reimbursement Manager to support patients, healthcare providers, and internal teams in navigating the reimbursement process for pharmaceutical products. This role ensures patient access to prescribed therapies by identifying and resolving reimbursement barriers, with a focus on compliance, documentation, and cross-functional collaboration.
What You'll Do
- Guide healthcare providers through the reimbursement process for including prior authorizations, appeals, and benefits verification.
- Work with insurance companies, payers, and third-party administrators to address coverage issues and ensure timely access to therapies.
- Provide education regarding insurance benefits and financial assistance programs.
- Ensure all reimbursement activities comply with federal and state regulations, as well as organizational policies.
- Maintain accurate and detailed documentation of all reimbursement activities, including case notes, payer communications, and patient outcomes.
- Work closely with cross-functional teams in a compliant manner.
- Provide insights to internal teams on reimbursement trends and challenges to inform strategic decision-making.
- Educate healthcare providers and internal teams on reimbursement processes, payer requirements, and available patient support programs.
- Stay up to date on changes in reimbursement policies and regulations to provide accurate guidance.
- Identify systemic issues in the reimbursement process and recommend solutions to improve efficiency and patient outcomes.
What We're Looking For
- Bachelor’s degree from an accredited institution required
- A minimum of 3 years of experience in reimbursement, patient access, and or pharmaceutical account management
- Knowledge of healthcare reimbursement from a patient and provider perspective including patient access processes, including prior authorizations, coding, and billing and other approaches to pursue coverage
- Understanding how products are covered under benefit design, including government and commercial payer policies.
- Familiarity with HIPAA regulations and patient privacy standards.
- Strong communication skills
- Skilled with technology tools and programs including Microsoft Office Suite, digital meeting platforms and other CRM platforms
- Successfully pass all required Amplity and client training
- Willingness to work in all US time zones as needed
Nice to Have
- A degree with a focus in healthcare administration, business, or a related field advantageous.
- Pharmaceutical experience preferred
- Direct experience coordinating with specialty pharmacies preferred
Technical Stack
- Microsoft Office Suite
- digital meeting platforms
- CRM platforms
Benefits & Compensation
- health
- dental
- vision
- company-funded disability
- 401K
- generous PTO
- paid holidays
- more
Bonus potential. Compensation range: $145K–$150K.
Work Mode
Remote position serving the US with flexibility to work across all US time zones.
We encourage and support equal employment opportunities for all associates and applicants for employment without regard to sex, race, color, religion, national origin, age, disability, marital status, sexual orientation or veteran status. Employment decisions are evaluated on the basis of an individual's skills, knowledge, abilities, job performance and other qualifications. In addition, Amplity Health maintains policies and procedures designed to comply with applicable federal, state and local laws governing non-discrimination in employment in every location in which Amplity Health has facilities.
