Our client is a huge name in the global healthcare industry and adding to the team. You will start with a specific pharmaceutical product, then evolve to other pharma launches as you grow your career.
Work Remotely from home! Live anywhere around Seattle WA or Portland OR . Working providers offices in this NW region (80% travel to provider offices)
This is a good role for someone with expertise in Specialty Reimbursement, Billing, Pull Throughs, can do provider training, and is ready for the next step in their career to an FRM role $100K
Must be an Expert in Health Insurance Billing & Reimbursement. Key Responsibilities: Provide virtual and on-demand education for the doctor's office staff in regard to Reimbursement challenges and support services that are available. Office interaction will include:
Educate:
- Benefit Investigation / Prior Authorization Process
- Support Center Services
- Medicare and Commercial coverage
- Educate on the patient communication streams
Reimbursement Support:
- Case management
- Billing and coding updates
- Appropriate claims submission
- Specialty Pharmacy
- Medical Benefit Interpretation
- Understanding medical necessity
- Claims / Appeal assistance
- Information related to co-pay assistance programs
- Information related to patient assistance programs
Responsible for
- setting up appointments and completing outbound calls to targeted offices.
- Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information.
- Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
- Research and compile provider / manufacturer representative specific information for reimbursement database.
- Utilize internal resources to proactively address areas of opportunity related to the overall customer experience.
- Utilize performance tracking tools & survey
Minimum Requirements
- BA degree in Business or Healthcare or a minimum of 6 years healthcare related reimbursement experience
- Bilingual Eng/Spanish
- Medical reimbursement experience with Specialty Pharmacy.
- Working with specialty pharmacy hubs
- Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.
- Medicare and commercial insurance coverage experience.
- Deliver and document benefit investigation outcomes and relay status reports on a regular basis.
- Ability to effectively handle multiple priorities within a changing environment.
- Strong Computer literacy
- Must include PowerPoint
- Must include Web Meeting experience
The best candidate for this role will have
- in addition to the above minimum requirements: Previous field territory experience
- Account management experience
- Excellent Interpersonal skills verbal and written
- Sense of customer advocacy
- Not a sales job!
Interviewing immediately for AN ASAP start date . True temp to hire role 100K+ base.
feel free to email Gloria.dambrisi@remx.com
