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Reimbursement Specialist
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Full-time
- The Reimbursement Specialist primarily responsible is to interface with Patients, HCPs and Payers by providing reimbursement support for activities related to benefit coverage, prior authorization, appeal denials, triage to specialty pharmacy and general inquiry.
- Assist with prior authorization and medical necessity processes, benefit verification and prior authorization assistance in a manner that is consistent with industry best practice.
- Determine network specialty pharmacy options and triage accordingly.
- Expert knowledge in patient assistance, reimbursement, medical benefit management, denials, and prior authorizations
- Knowledge of healthcare administration and specifically healthcare billing and reimbursement procedures and regulations
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