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Claims Specialist
3 months ago
Title: Reimbursement Specialist 1
Duration: 6 months
Pay Rate : $27.50/hr on W2
Location - East Hanover, NJ 07936
Shift: Actual hours will be 8am-5pm EST shift
Training is a mix of on-site in East Hanover, NJ and virtual for from 8am – 5pm and will be 8-10 weeks.
Overview:
The Reimbursement Specialist will be responsible for providing support and information about the insurance coverage of their prescribed Clients 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.
• 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 Clients programs over time
• As applicable, raise innovative ideas which will drive improved efficiency and effectiveness of customer service to Team Leads.
What you’ll bring to the role:
Education:
High School Diploma required
Travel requirements:
Proximity and ability to commute to work onsite in East Hanover minimally 1 week per month and for occasional meetings or events
Other Work Requirements:
When working from home, a quiet dedicated space with internet/WiFi service or the ability to obtain such service (Cleint offers a subsidy to partially cover the cost of this technology) where the employee can work without interruption
Ability to work the scheduled work hours, which generally will be an 8-hour schedule with two paid rest breaks and an unpaid lunch break.
Experience:
• Required Experience:
~6 months of proven Reimbursement Experience (such as Healthcare, Payers or Pharmaceuticals,)
Salesforce highly desired but not required
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 direc-tions
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.
