Insurance Reimbursement Coordinator
2 weeks ago
Position Overview:
Title: Reimbursement Specialist I
Duration: 6 months
Compensation: $27.58/hr
Shift: 8am-5pm EST during training and post-training
Location: East Hanover, NJ
Role Summary:
The Reimbursement Specialist is tasked with delivering support and insights regarding insurance coverage for prescribed medications. This role requires the accurate identification of patient insurance plans and the fulfillment of necessary requirements through the use of reimbursement tools, while also collaborating with payers and healthcare providers.
Additionally, the Reimbursement Specialist may relay pertinent information to Patient Specialty Services teams, addressing coverage inquiries, facilitating pre-authorizations for medical services, and clarifying co-payment details.
Strong communication skills are essential for engaging with payors and providers regarding benefits coverage, while offering solutions that align with established protocols.
Key Responsibilities:
- Develop and enhance knowledge of Patient Support Services programs and payer coverage, expanding expertise over time.
- Utilize established protocols and technology to gather patient coverage information, including making prompt and courteous phone calls to payers.
- Prepare necessary documentation and notifications, ensuring proper escalation, tracking, and follow-up.
- Adapt skills to navigate the payer landscape related to Novartis programs as expertise grows.
- Propose innovative ideas to improve efficiency and effectiveness in customer service to Team Leads.
Qualifications:
Education:
High School Diploma is required.
Travel Requirements:
Ability to commute to the designated site as needed for occasional meetings or events, based on business discretion.
Work Environment:
When working remotely, a quiet and dedicated workspace is necessary to ensure uninterrupted productivity.
Training Requirements:
Successful completion of initial training, including passing simulations, is required to become certified for the role.
Experience:
Required:
- Approximately 6 months of relevant experience in reimbursement roles within healthcare, payers, or pharmaceuticals.
- Ability to manage multiple priorities effectively.
- Experience with data entry systems, fax machines, and communication technologies.
- Strong verbal communication skills, with the ability to follow both oral and written instructions.
- Proficient problem-solving and critical thinking abilities.
- Capacity to accurately document payer conversations in a timely manner.
- Computer literacy, including familiarity with email and video conferencing tools.
Preferred:
- 1 year of experience as a Reimbursement Specialist in a Customer Contact Center within the pharmaceuticals sector.
Therapeutic Area Experience:
No specific therapeutic area experience is required.
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