Insurance Reimbursement Specialist

job summary :

As the world's largest staffing and recruitment agency in the world, we can commit to find you the perfect role that gives you the opportunity to learn and grow in the life sciences arena.

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We supply prestigious life sciences and biopharma companies with job seekers like you to achieve their business goals. If you're looking for a position where you can serve as an asset to your company while making a difference in others' lives, we have the ideal position for you!

responsibilities : Job Description

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.

qualifications :

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

Travel requirements :

Proximity and ability to commute to work onsite in East Hanover 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 East Hanover site.

Other Work Requirements :

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

Ability to work the scheduled work hours, which generally will be an 8-hour schedule with two paid rest breaks and an unpaid lunch break.

Schedule 1 hours : 8 am - 5 pm ET, Schedule 2 hours : 10 am - 7 pm ET, Monday through Friday. Subject to change.

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 conf

skills : Administration

Administration