Field Reimbursement Manager

🔥 13 hours ago

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CareMetx, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

⚕️ Healthcare Insurance

Healthcare Insurance

CareMetx, LLC is a company that specializes in transforming patient access to specialty therapeutics by reducing the time to therapy. They offer a digital Hub service that addresses emotional, financial, and clinical barriers for patients, aiming to improve treatment timelines and ongoing therapy use. CareMetx provides high-touch support and utilizes advanced technology to offer solutions for access, affordability, and adherence, benefiting both patients and healthcare providers. They partner with specialty pharmaceutical brands, healthcare providers, and hospital systems to enhance patient outcomes.

📋 Description

• Interact with key stakeholders within healthcare provider clinics, physician practices, or hospital outpatient locations • Act as a liaison between healthcare provider offices and CareMetx program teams to support complex reimbursement cases • Take the lead on complicated or escalated reimbursement cases in assigned territory • Validate Prior Authorization and Appeal Requirements and communicate as needed to stakeholders • Track electronic payer billing codes for pharmacy and medical payers • Develop Appeal Package for patient support program; ensures communication occurs between stakeholders on status of Appeal, if applicable • Assist program teams with handling escalated medical and pharmacy billing challenges • Assist with resolving reimbursement challenges

🎯 Requirements

• 5 + years’ experience working with specialty healthcare providers for both pharmacy and medical billing (including buy and bill) • Experience with Retinal is highly preferred • Technical knowledge of healthcare reimbursement including coding, billing, appeals process, and navigating complex reimbursement issues with both patients and providers • Advanced degree or specific Practice Management experience preferred

🏖️ Benefits

• Exceptional customer service to internal and external customers • Flexible work arrangements • Professional development opportunities