Reimbursement Specialist

🕒 June 1

⚔️ Virginia – Remote

⚔️ Virginia – Remote

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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VCU Health

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

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

• Improves revenue collection pertaining to high cost medications that require prior authorization • Initiates, follows-up, and proceeds with approval and/or denials of prior authorizations efficiently via phone, fax, or electronically • Carries out benefit investigation and coordinates Patient Assistance Programs and/or copay cards for patients with high co-pays or those without insurance coverage • Works closely with nursing and physicians in order to obtain required documentation for prior authorization and billing • Arranges refills, transfers, and delivery of medications • Updates patient case management system regularly

🎯 Requirements

• Minimum of one (1) year of previous pharmacy practice experience in a similar setting • Minimum of three (3) years of prior experience with Manufacturers Patient Assistance Programs and prior experience with prescription on-line adjudication • Previous work experience using a personal computer and various billing software applications as well as e-mail, spreadsheets, word processing, databases, etc. • Current certification by the Pharmacy Technician Certification Board (PTCB) • Current licensure with the Virginia State Board of Pharmacy

🏖️ Benefits

• N/A