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Healthcare Reimbursement Specialist
2 months ago
CornerStone Staffing is seeking a skilled professional to fill a Reimbursement Case Manager position. The ideal candidate will possess experience in healthcare and a strong understanding of medical claims and reimbursement processes.
**Key Responsibilities:**
- Provide exceptional customer service and case management to patients, pharmacies, and healthcare providers.
- Collect and review patient information in compliance with HIPAA regulations.
- Serve as a patient advocate, enhancing the caller/contact experience.
- Determine patient eligibility and conduct patient enrollment activities.
- Perform reimbursement-related activities, including benefit investigations, prior authorizations, and appeals.
**Requirements:**
- 3+ years of experience in a specialty pharmacy, medical insurance, physician's office, or healthcare setting.
- Bachelor's degree preferred.
- Knowledge of HIPAA regulations.
- Knowledge of pharmacy benefits and medical benefits.
- Competency in MS Word and Excel.
**Application Process:**
- Clerical testing.
- Background check.
- Drug testing.
