Medical Reimbursement Specialist

7 days ago


Western Springs, Illinois, United States ProPharma Group Full time
Job Description

 

About ProPharma Group

 

At ProPharma Group, we improve the health and wellness of patients by providing advice and expertise that empowers biotech, med device, and pharmaceutical organizations to advance scientific breakthroughs and introduce new therapies.

 

We partner with our clients through an advise-build-operate model across the complete product lifecycle. With deep domain expertise in regulatory sciences, clinical research solutions, quality & compliance, pharmacovigilance, medical information, and R&D technology, we offer an end-to-end suite of fully customizable consulting solutions that de-risk and accelerate our partners' most high-profile drug and device programs.

 

Job Overview

 

The Patient Services Reimbursement Case Manager plays a pivotal role in ensuring patients receive timely access to their prescribed medications while expertly navigating complex reimbursement processes.

 

This role goes beyond reimbursement coordination to include patient intake, customer service, and ongoing support, all with a strong focus on patient-centric care. The ideal candidate will be instrumental in providing compassionate and personalized support to patients, addressing their unique needs and concerns throughout their treatment journey.

 

Responsibilities:

  • Reimbursement Coordination
  • Billing and Insurance Verification
  • Prior Authorizations
  • Appeals Support
  • Financial Assistance Programs
  • Patient Intake and Onboarding
  • Customer Service and Support
  • Collaboration and Communication
  • Patient Advocacy and Education
  • Quality Assurance and Compliance

 

Requirements:

 

A minimum of 5 years of experience in patient services/support and access, including patient financial assistance, reimbursement coordination with pharmacy and medical benefits, prior authorizations, appeals, medical coding, coverage policies, and policy management is required.

 

A Bachelor's degree in a relevant field such as Healthcare Administration, Business, or a related discipline is preferred, but not required. In lieu of a bachelor's degree, candidates must possess a minimum of 5-7 years of expertise in patient services, insurance reimbursement, insurance verification, both medical and pharmacy and/or medical coding and billing, and/or pharmacy technician experience.

 

An active Pharmacy Technician License or Certified Pharmacy Technician (CPHT) certification is also preferred. If not currently licensed, the candidate must secure the necessary licensure within 30 days of hire.

 

What We Offer:

 

We celebrate our differences and strive to create a workplace where each person can be their authentic self. We are committed to diversity, equity, and inclusion. Employees are encouraged to unleash their innovative, collaborative, and entrepreneurial spirits. With a holistic approach as an Equal Opportunity Employer, we provide a safe space where all employees feel empowered to succeed.

 

Estimated Salary: $65,000 - $85,000 per year

 

Location: Remote

 

Please note that the estimated salary range may vary based on location and other factors. We encourage applicants to inquire about specific salary ranges during the hiring process.



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