Reimbursement Specialist

2 weeks ago

East Hanover, United States Randstad Life Sciences Full time $26 - $27
Job DescriptionJob Description

Job  Title - Reimbursement Specialist I 

Duration: 6 months 

Hours: 8am-5pm EST shift shift during training as well as after training.

Pay Rates: $27.58/hr

Location - East Hanover, NJ

HIRING TIMELINE:
Resume Submittals - 07/25 - 08/16
Interviews Conducted - 07/29 - 08/23
Last Offer Deadline - 08/28
Background Checks Conducted - 08/28 - 09/13
Background Check Completed - 09/13
Start Date - 09/23
 

“The Reimbursement Specialists are primary responsible for calling Pharmacy Benefit Managers as well as medical payers to obtain patient’ benefits (i.e., confirming plan details, obtaining cost information, patient responsibility, prior authorization/appeal requirements, etc.). Reimbursement Specialists are then responsible for calling the payers to follow up on the status of the coverage exceptions (PA, appeal, NFE). They are also responsible for documenting this information and sending it via fax to healthcare providers, so we are also looking for candidates with strong written/verbal skills. There have also been instances where resumes have had typos, grammatical errors, etc., which is sometimes a red flag. Lastly, there is no billing/claims support associated with this role, but since the title is Reimbursement Specialist, many people assume that those responsibilities are included in the job description.”

Hours:

  • East Hanover: 8am-5pm EST schedule, this will be consistent, hours will not change
  • Onsite/remote
  • Will come in to get their computers, etc., might need to come onsite every so often during training
  • After training schedule is onsite M-F 1 week per month, then the next 3 weeks will be remote
  • The office is available on remote days for workers to come in and work if they prefer

Interview process

  • Will screen the resumes, then schedule interviews
  • 1-2 interviews total, will interview with two people at a time, but will move quickly, if there is a second round it will follow quickly after the first round

Job Description

The Reimbursement Specialist will be responsible for providing support and information about the insurance coverage of their prescribed client 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.

Your responsibilities will include, but are not limited to:
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 client 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 Tempe, AZ as required by our hybrid model for occasional meetings or events. To be scheduled at the discretion of the business.
This job requires you live within 90 miles of the Tempe, AZ site of client.

Other Work Requirements:
When working from home, a quiet dedicated space with where the employee can work without interruption

For Patient Support Center (PSC) Roles with a Dedicated Training Period: The individual hired for this role will be required to successfully complete initial training, including passing simulations and become certified to do the role.

Experience:
Required Experience:
~6 months of proven Reimbursement Experience (such as Healthcare, Payers or Pharmaceuticals,)
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 directions
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.

Company DescriptionSupportive work environment and excellent cultureCompany DescriptionSupportive work environment and excellent culture

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