Senior Reimbursement Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

⏳ Contract/Temporary

🟠 Senior

👻 Ghost score 10%

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UBC

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

🏥 Healthcare

💼 Consulting

🧬 Biotechnology

Healthcare • Consulting • Biotechnology

UBC is a company dedicated to improving patient outcomes by connecting specialty therapies to patients in need. They provide modern and customized solutions focusing on access, safety, and evidence generation for biopharmaceutical products. UBC specializes in evidence development, risk management, and patient access, utilizing real-world data and innovative technologies to optimize the healthcare journey and ensure effective medication use.

📋 Description

• Conduct outbound calls to insurance payers to complete Pharmacy Benefit Manager (PBM) and Medical Management (MM) benefit verifications • Conduct benefit investigations and verify insurance benefits for patients and physicians’ offices • Submit and obtain prior authorizations as required by payers • Obtain recertification for cases requiring extended treatment or coverage • Accurately enter and maintain data in the client database and patient files • Monitor outstanding items on client case files and ensure files are complete • Participate in conference calls with Client Sales Representatives, client management, and physicians’ offices regarding case status, drug orders, and alternative funding • Coordinate product orders, shipments, and therapy initiation with pharmacies and patients • Participate in call center activities, including triaging and responding to incoming calls • Serve as a single point of contact for an assigned group of prescribers, as needed • Identify and report events in accordance with REMS requirements • Recognize adverse events, product quality complaints, and potential risk events and forward information for manufacturer reporting • Educate patients, prescribers, and others regarding program requirements and facilitate referrals • Maintain quality and production standards and comply with company, state, and federal safety and environmental procedures

🎯 Requirements

• High School Diploma/GED or equivalent experience • 4–6 years’ experience in the insurance, biotechnology, or pharmaceutical industries; customer service and/or reimbursement • Health Insurance claims or patient accounting experience a plus • Computer proficiency in MS Office applications, with database experience a plus • Excellent written and verbal communication skills, with demonstrated ability to communicate with others at all levels • Ability to manage multiple priorities and meet deadlines • Detail oriented with good analytical skills • Knowledge of third party billing, coding, medical terminology, prior authorizations and appeals preferred • HIPAA-compliant workspace • Reliable high-speed internet • Availability Monday through Friday, 9:00 AM–6:00 PM EST, with no flexibility in the shift

🏖️ Benefits

• Remote opportunities • Competitive salaries • Growth opportunities for promotion • 401K with company match* • Tuition reimbursement • Flexible work environment • 20 days PTO • Paid Holidays • Employee assistance programs • Medical, Dental, and vision coverage • HSA/FSA • Telemedicine (Virtual doctor appointments) • Wellness program • Adoption assistance • Short and long term disability • Life insurance • Discount programs • UBC will provide all required equipment, including desktop hardware and software