Reimbursement Case Manager

3 days ago Be among the first 25 applicants

This range is provided by TalentBridge. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$18.00/hr - $20.00/hr

Job Title: Reimbursement Case Manager
Location: Remote (Candidates must reside in North or South Carolina)
Schedule: 11:00 AM - 8:00 PM EST
Type: Contract

Job Title: Reimbursement Case Manager
Location: Remote (Candidates must reside in North or South Carolina)
Schedule: 11:00 AM - 8:00 PM EST
Type: Contract

We are seeking a dedicated and compassionate Reimbursement Case Manager to join our fully remote team. In this role, you will serve as a key point of contact for patients, healthcare providers, and pharmacies, supporting access to therapies and ensuring a seamless patient experience. You will coordinate benefits investigations, prior authorizations, appeals, and patient assistance programs, advocating for patients throughout their treatment journey.

• Serve as a single point of contact and advocate for patients and providers, always demonstrating compassion and professionalism.

• Support patients in accessing therapy and appropriate support services, including coordinating benefits and reimbursement activities.

• Manage case loads effectively in alignment with program requirements.

• Collect and review patient information, ensuring completeness and accuracy.

• Guide physician office staff and patients on completing and submitting program applications.

• Determine patient eligibility and conduct enrollment activities for patient assistance and copay programs.

• Perform reimbursement activities such as benefits investigations, prior authorizations, and appeals.

• Provide exceptional customer service, resolving inquiries in a timely and accurate manner.

• Maintain regular phone contact with patients, providers, payers, and pharmacies.

• Provide reimbursement information and support to providers and/or patients.

• Report adverse events in compliance with applicable guidelines.

• Collaborate with internal team members as needed to ensure optimal case resolution.

• Work within defined standard operating procedures and exercise sound judgment.

• Follow all HIPAA regulations and company policies.

• Other duties as assigned.

Experience and Education Requirements:

• Must have prior case management experience.

• Must have experience working in a specialty pharmacy setting.

• Must have experience with medical reimbursement processes (e.g., benefits investigations, prior authorizations, appeals).

• Minimum 3+ years of relevant experience in a specialty pharmacy, medical insurance, reimbursement hub, physician’s office, or healthcare setting.

• Bachelor’s degree preferred.

Skills and Competencies:

• Excellent verbal and written communication skills.

• Ability to multi-task and adapt to changing priorities.

• Strong keyboard and computer skills; proficiency in MS Word and Excel.

• In-depth understanding of HIPAA regulations.

• High attention to detail and strong organizational skills.

• Strong interpersonal and customer service skills.

• Knowledge of pharmacy and medical benefits.

• Understanding of commercial and government payer systems preferred.

• Ability to work independently and as part of a team.

• Problem-solving mindset and commitment to customer satisfaction.

• General office requirements applicable to a remote work environment.

If you have a passion for helping patients navigate complex healthcare systems and meet the required experience, we encourage you to apply today!

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Contract

Job function

• Job function

  Customer Service and Health Care Provider

• Industries

  Pharmaceutical Manufacturing

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