Reimbursement Specialist

Job not on LinkedIn

🕒 August 5

⚔️ Virginia – Remote

⚔️ Virginia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

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👻 Ghost score 25%

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VCU Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

VCU Health is an academic medical center dedicated to advancing medicine and improving community health. With over 800 physicians across 200 clinical specialties, it offers a wide range of services including cancer care, heart and vascular services, neurosciences, orthopaedics, pediatrics, emergency care, and telehealth. VCU Health integrates cutting-edge technology and clinical expertise to make medical advancements a reality. It operates various hospitals and comprehensive care centers, including the VCU Medical Center in Downtown Richmond and the Children's Hospital of Richmond. VCU Health also emphasizes research and clinical trials to push the boundaries of what's possible in medicine.

📋 Description

• Improve revenue collection for high-cost medications requiring prior authorization • Initiate, follow up on, and process approval or denial of prior authorizations via phone, fax, or electronic systems • Conduct benefit investigations • Coordinate Patient Assistance Programs and copay cards for patients with high copays or no insurance coverage • Work with nursing and physicians to obtain documentation for prior authorization and billing • Arrange medication refills, transfers, and deliveries • Regularly update the patient case management system • Research disease-state terminology as needed • Work as a Pharmacy Technician when necessary • Identify equipment problems and assist the pharmacist with tasks not requiring pharmacist supervision or verification

🎯 Requirements

• Current Pharmacy Technician Certification Board (PTCB) certification • Current licensure with the Virginia State Board of Pharmacy • Clean criminal record with no felony conviction or drug/pharmacy-related convictions, including misdemeanors • No denial, suspension, revocation, or restriction of pharmacy registration or licensure • Minimum of 1 year of previous pharmacy practice experience in a similar setting • Minimum of 3 years of experience with manufacturers' Patient Assistance Programs • Prior experience with prescription online adjudication • Experience using a personal computer and billing software applications • Experience with email, spreadsheets, word processing, databases, and related applications • Ability to work all shifts, weekends, holidays, and emergency coverage • Strong recall, reasoning, problem solving, hearing, clear speech, legible writing, reading, and logical thinking • Ability to handle multiple priorities, frequent and intense customer interactions, and frequent change • Physical ability for prolonged standing and sitting, frequent bending, walking, climbing, overhead/repetitive reaching, and repetitive motion • Ability to lift less than 20 lbs. • Associate's Degree in Business or related field is preferred

🏖️ Benefits

• Full-time employment • EEO Employer/Disabled/Protected Veteran