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Reimbursement Specialist I

2 months ago

East Hanover, United States Randstad Life Sciences Full time
Job DescriptionJob Description

The company's purpose is to reimagine medicine to improve and extend people's lives. We use innovative science and technology to address some of society's most challenging healthcare issues. We discover and develop breakthrough treatments and find new ways to deliver them to as many people as possible.

Job Description

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

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 DescriptionA great company doing groundbreaking and important work with a great reputation in the industryCompany DescriptionA great company doing groundbreaking and important work with a great reputation in the industry