Novocure · 1 day ago
Reimbursement Specialist I
Portsmouth, NH
Full-time
Onsite
New Grad, Entry Level
0+ years expNovocure is dedicated to extending survival in aggressive forms of cancer through innovative therapies. The Reimbursement Specialist I plays a crucial role in executing reimbursement processes to ensure medical necessity and secure accurate payments, thereby reducing financial impacts on patients.
BiotechnologyHealth CareMedical DeviceOncology
Responsibilities
Conduct timely insurance benefit verifications to determine patient eligibility and cost-share responsibilities for both new and existing patients
Accurately identify the appropriate “bill-to” insurance party
Submit prior authorization requests to insurance carriers and follow up via phone or insurance portals with minimal supervision
Interpret authorization denials and draft appeals, when necessary, with limited supervision
Research and interpret commercial payer medical policies and coverage guidelines
Verify the presence and accuracy of authorizations and pricing agreements for all insured patients
Differentiate between contract and non-contract carriers, including identifying contacts for potential letter of agreement (LOA) negotiations
Escalate contracting implementation challenges and identify opportunities for process improvement
Collaborate cross-functionally with other departments to ensure timely and accurate reimbursement from insurance providers
Ability to follow up on outstanding insurance balances via phone and insurance website promptly
Investigate and resolve all incorrect payments and escalate trends in change behavior as identified
Submit and track the status of claim appeals for payment disputes
Identify the need for a claims project
Communicate with key personnel within managed care organizations, such as nurse case managers, to streamline the reimbursement processing for patients
Perform additional duties and respond to shifting priorities as assigned by management
Qualification
Required
Maintain integrity and tenacity while working accounts
Ability to effectively de-escalate and resolve difficult situations
Proven written and verbal communication skills with internal and external customers
Ability to work independently with limited supervision
Ability to work efficiently and cooperatively in a fast-paced office setting
Demonstrated knowledge of medical and insurance terminology
Demonstrated effectiveness in communicating with insurance companies about medical policies and contracts
Preferred
Bachelor's degree or equivalent experience
0-2 years' experience in a reimbursement-related function, DME-specific experience
In-Depth Knowledge of Microsoft Office and SAP
Ability to lift up to 20 pounds
Company
Novocure
An Oncology Company Pioneering a Novel Therapy for Solid Tumors
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
$1BKey Investors
Pharmakon AdvisorsJP Morgan ChaseBioPharma Credit
2024-05-02Post Ipo Debt· $100M
2020-11-09Post Ipo Debt· $150M
2020-11-05Post Ipo Debt· $575M
Leadership Team
Asaf Danziger
Chief Executive Officer
Mike Ambrogi
Chief Operating Officer
Recent News
2026-01-13
Company data provided by crunchbase