Reimbursement Specialist - Remote

Overview

The Reimbursement Specialist improves revenue collection pertaining to high-cost medications that require prior authorization, coordinating with patients, nursing, and physicians to ensure efficient processing of approvals and denials.

In Short

• Initiate and follow up on prior authorizations.
• Conduct benefit investigations for patients.
• Coordinate Patient Assistance Programs and copay cards.
• Work closely with nursing and physicians for documentation.
• Arrange medication refills, transfers, and deliveries.
• Maintain patient case management systems.
• Possess familiarity with disease state terminology.
• Work as a Pharmacy Technician when necessary.
• Meet licensure and certification requirements.
• Adapt to a fast-paced environment and handle multiple priorities.

Requirements

• Current certification by the Pharmacy Technician Certification Board (PTCB).
• Current licensure with the Virginia State Board of Pharmacy.
• Minimum of one year of pharmacy practice experience.
• Three years of experience with Patient Assistance Programs.
• Experience with billing software and computer applications.
• High School Diploma or equivalent required.
• Associate's Degree in Business preferred.
• Ability to work all shifts, weekends, and holidays.
• Clean criminal record required for employment.
• Physical ability to perform job tasks including lifting and prolonged standing.

Benefits

• Opportunity to work in a dynamic healthcare environment.
• Engagement with a diverse team of healthcare professionals.
• Contribute to improving patient care and access to medications.
• Gain experience in the pharmaceutical and healthcare industry.
• Potential for career growth within the organization.