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UBC · 18 hours ago

Sr. Reimbursement Specialist - Patient Access Services Hub

United States

Full-time

Remote

Mid, Senior Level

4+ years exp

UBC is a pharmaceutical support industry leader devoted to empowering health solutions for a better tomorrow. The Sr. Reimbursement Specialist focuses on providing exceptional customer service by coordinating between patients, healthcare providers, insurance companies, and pharmacies to ensure timely access to client products and maximize reimbursement.

BiotechnologyHealth CareLife ScienceMedical

Responsibilities

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

Qualification

Insurance verificationPrior authorizationsCustomer serviceMS Office proficiencyThird party billingMedical terminologyAnalytical skillsCommunication skillsDetail oriented

Required

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