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Sr. Reimbursement Specialist

Remote: 
Full Remote
Experience: 
Senior (5-10 years)

UBC logo
UBC Pharmaceuticals Large https://www.ubc.com/
1001 - 5000 Employees
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Job description

Exciting opportunities await as the Mallinckrodt team continues to demonstrate its impact and success. We recognize the value of UBC’s internal talent and invite you to showcase your unique perspective and skills on a new team. This program will provide a platform for you to showcase your capabilities, take on new responsibilities, and develop professionally

If you are passionate, driven, and ready to take on new challenges, we encourage you to seize this incredible opportunity. 

Shape the future, apply today, and let your talent shine within UBC!

Job Title:  

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:

  • High School Diploma/GED or equivalent experience
  • 4 – 6 years’ experience in the insurance, biotechnology, or pharmaceutical industries; customer service and/or reimbursement. Health Insurance claims or patient accounting experience a plus.
  • Computer proficiency in MS Office applications, with database experience a plus.
  • Excellent written and verbal communication skills, with demonstrated ability to communicate with others at all levels.
  • Ability to manage multiple priorities and meet deadlines. 
  • Detail oriented with good analytical skills. 
  • Knowledge of third party billing, coding, medical terminology, prior authorizations and appeals preferred.

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 
  •  20 days 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 

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.

#LI-MR1 

#LI-Remote

Required profile

Experience

Level of experience: Senior (5-10 years)
Industry :
Pharmaceuticals
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Customer Service
  • Analytical Skills
  • Time Management
  • Detail Oriented
  • Communication

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