Position Summary
- The Reimbursement Specialist will be responsible for providing support and information about the insurance coverage of their prescribed Client medicines. They will accurately and efficiently find the patient’s insurance coverage, and any other requirements by leveraging reimbursement tools and collaborating with payers and providers.
- The Reimbursement Specialist may also share appropriate information with Patient Specialty Services field teams. This information may cover coverage-related queries from customers, provide pre-authorizations for medical treatment, and outline information regarding co-payments.
- The Reimbursement Specialist must have strong communication skills to converse with payors and providers about benefits coverage and be able to offer solutions in accordance with approved procedures.
- A Reimbursement Specialist will possess an aptitude for learning and continual development.
Responsibilities:
Your responsibilities will include, but are not limited to:
- Develop and maintain knowledge of PSS programs and payer coverage; broaden program knowledge over time.
- Learn and utilize protocols, information and technology to gather patient coverage information. Some of this will be completed via phone calls to payers in a prompt and courteous manner.
- Prepare proper documentation and notifications; perform proper escalation, tracking, and follow-up.
- Evolve skills to navigate the payer landscape regarding the Client programs over time.
- As applicable, raise innovative ideas which will drive improved efficiency and effectiveness of customer service to Team Leads.
Qualifications:
- Education: High School Diploma required.
Travel requirements:
- Proximity and ability to commute to work onsite in East Hanover as required by our hybrid model for occasional meetings or events.
- To be scheduled at the discretion of the business.
- This job requires you live within 90 miles of the East Hanover site.
Other Work Requirements:
- When working from home, a quiet dedicated space with where the employee can work without interruption.
- For Patient Support Center (PSC) Roles with a Dedicated Training Period: The individual hired for this role will be required to successfully complete initial training, including passing simulations and become certified to do the role.
Required Experience:
- ~6 months of proven Reimbursement Experience (such as Healthcare, Payers or Pharmaceuticals).
- Experience and exposure in balancing multiple priorities with multiple audiences.
- Experience working with data entry system(s), fax machines, computer software, and telephone technology.
- Strong phone and verbal communication skills – ability to follow oral and written directions.
- Good problem-solving and critical thinking skills.
- Ability to interpret, capture and document the details of payer conversations, in a timely and efficient manner.
- Computer literacy with email, video conferencing systems and data entry systems.
Preferred Experience: 1 year of Reimbursement Specialist experience within a Customer Contact Center in the Pharmaceuticals industry.
Therapeutic area experience: No therapeutic area experience required.