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Sr. Reimbursement Specialist

Remote:

Full Remote

Contract:

Full time

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

Bachelor's degree or six years experience, Two years in pharmacy benefit management preferred, Experience as Medical Assistant, Social Worker, or Senior Reimbursement Specialist preferred, Proficient in Microsoft Office applications, Knowledge of medical and claims processing terminology.

Key responsabilities:

Conduct benefit investigations and verify insurance benefits
Submit and obtain prior authorizations as needed
Participate in calls regarding case statuses and treatment
Triage incoming calls from patients and providers
Educate patients on program requirements and facilitate referrals

UBC Pharmaceuticals Large https://www.ubc.com/

1001 - 5000 Employees

See more UBC offers

Job description

Your missions

As leaders in the pharmaceutical support industry, UBC is devoted to empowering health solutions for a better tomorrow. We take pride in improving patient outcomes and advancing healthcare. At UBC we provide services to enhance the entire drug development process and commercialization lifecycle - from clinical trial support to real-world evidence generation.

Embark on a rewarding career journey with UBC! Grow your career while making a meaningful impact on the world around you. UBC fosters a culture built on our Core Values of Respect, Accountability, Innovation, Quality, Integrity, and Collaboration. We believe in an inclusive workplace that fosters creativity.

If you are seeking a career that will challenge, inspire, and reward you, join us at UBC!

CEG02E – Sr. Reimbursement Specialist

Brief Description:

The primary goal of this position is to provide high quality customer service, effectively interface with patients, patient’s families, national payers, home cares and medical doctor’s offices to assist patient and medical provider in expediting the process starting the patient on client product, and ensure the highest level of reimbursement is attained for client product. Extensive knowledge in specialized functions with a wide and comprehensive acquaintance with and understanding of both general and specific aspects of the job and their practical application to complex problems and situations ordinarily encountered.

Specific job duties:

Conduct benefit investigations, verify insurance benefits for patient and physicians’ offices, and submit and obtain prior authorizations as required by payer; obtain recertification for cases requiring extended treatment/coverage beyond the expiration of original approval.
Accurately enter and maintain data as required in client database and patient files and utilize the client database to monitor outstanding items on each client case file. Ensure files are complete so team can determine the current status.
Participate in conference calls as needed with Client Sales Representatives, client management and physicians’ offices regarding status of cases, drug orders and status of alternative funding.
Provide coordination of order for product, shipment of product, and therapy initiation with pharmacy and patient.
Participate in Call Center Activities, triage and respond to incoming calls from patients, insurance companies, physicians, Sales Reps, pharmacies and homecare agencies. May serve as single point of contact for an assigned group of prescribers.
Identify and report events as required by the REMS requirements for specified medication. Recognize adverse event, product quality complaint, potential risk events, and forward information to the appropriate team member for reporting to the manufacturer.
Educate patients, prescribers, and others regarding program requirements, and facilitate referrals. Maintain good housekeeping techniques, adhering to quality and production standards and comply with all applicable company, state, and federal safety and environmental programs and procedures.

Supervisory Responsibility:

N/A

Desired Skills and Qualifications:

Bachelor’s degree or six years of relevant working experience
Two (2) or more years of relevant experience in pharmacy benefit management preferred
Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred
Proficient in MicroSoft Office applications
Knowledge of medical and claims processing terminology
Excellent written/verbal communication to include providing clear instructions
Must possess a strong critical thinking skillset along with the ability to multi-task

Benefits:

At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally.

Here are some of the exciting perks UBC offers:

Remote opportunities
Competitive salaries
Growth opportunities for promotion
401k with company match*
Tuition reimbursement
Flexible work environment
Discretionary PTO (Paid Time Off) OR 20 days (about 3 weeks) of PTO
Paid Holidays
Employee assistance programs
Medical, Dental, and vision coverage
HSA/FSA
Telemedicine (Virtual doctor appointments)
Wellness program
Adoption assistance
Short term disability
Long term disability
Life insurance
Discount programs

DEI Statement

UBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class. We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients.