Reimbursement Case Manager - Remote

Overview

The Reimbursement Case Manager at CareMetx is responsible for managing customer service and case management, ensuring patients have access to specialty therapies while adhering to HIPAA regulations.

In Short

• Acts as a single point of contact for providers and patients.
• Coordinates access to therapies and support services.
• Manages case load based on program parameters.
• Validates patient information and assists with applications.
• Conducts patient eligibility and enrollment activities.
• Performs reimbursement activities like benefit investigations and appeals.
• Provides exceptional customer service to internal and external customers.
• Maintains frequent contact with patients and healthcare providers.
• Reports adverse events in compliance with training.
• Works independently and in collaboration with team members.

Requirements

• 3+ years of experience in a healthcare or reimbursement setting preferred.
• Bachelor’s Degree preferred.
• Excellent verbal and written communication skills.
• Ability to multi-task and adapt to changing priorities.
• Proficient in MS Word and Excel.
• Knowledge of HIPAA regulations.
• Detail-oriented and highly organized.
• Strong interpersonal skills.
• Understanding of pharmacy and medical benefits.
• Customer satisfaction focused.

Benefits

• Flexible schedule with potential overtime.
• Opportunity to work in a supportive environment.
• Engagement in a meaningful industry.
• Equal opportunity employer.