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UBC logo
UBC

Patients First. Powered by Evidence.

Case Manager – Reimbursement

ManagerManagerFull TimeRemoteMid LevelTeam 1,001-5,000Since 2003H1B No SponsorCompany SiteLinkedIn

Location

Florida + 1 moreAll locations: Florida | Missouri

Posted

84 days ago

Salary

0

Seniority

Mid Level

Bachelor Degree2 yrs expExperience acceptedEnglish

Job Description

Case Manager – Reimbursement

UBC

• Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required. • Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders. • Communicate patient benefits and responsibility timely and accurately. • Assess and refer patients appropriately for special programs/services when appropriate. • Performs quality checks on cases and report trends to leadership. • Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures. • Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy. • Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements. • Recognize a product quality complaint and forward caller/written information to a manufacturer. • Other duties, as assigned.

Job Requirements

  • 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

Benefits

  • Remote opportunities
  • Competitive salaries
  • Growth opportunities for promotion
  • 401k with company match*
  • Tuition reimbursement
  • Flexible work environment
  • 20 Days PTO Annually (accrued)
  • 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

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