Cell & Gene Reimbursement Specialist

Mckesson Corporation; Cary (NC); Hybrid; USD 27,000 - 46,000; Full time

Job summary

McKesson is seeking a Cell and Gene Insurance Reimbursement Specialist to support reimbursement for life-changing therapies. This hybrid role requires two days in the office weekly at Cary, NC or Ft. Worth, TX, and demands strong knowledge of insurance processes and medical billing.

You will verify coverage, manage appeals, and collaborate with payers, providers, and patient advocates to improve access while ensuring regulatory compliance. Experience in specialty pharma is essential.

Qualifications

• Typically requires 5+ years of related experience.
• Experience in the specialty healthcare or pharmaceutical segment with understanding of healthcare continuum and relationship between manufacturers, patients, providers, and payers.
• Strong understanding of health insurance coverage and reimbursement processes, including knowledge of medical coding and billing practices.
• Familiarity with cell and gene therapies and the associated reimbursement landscape is a plus.

Responsibilities

• Verify patients' insurance coverage and benefits for cell and gene therapies, including pre-authorization requirements, limitations, and exclusions.
• Manage appeals and denials related to authorizations and insurance claims for cell and gene therapies.
• Maintain detailed records of insurance reimbursement activities and generate reports as needed.
• Stay up to date with evolving insurance regulations and policies related to cell and gene therapies, ensuring compliance.
• Provide guidance and support to patients and their families regarding insurance coverage and financial assistance programs.
• Collaborate with cross-functional teams to streamline reimbursement processes and improve patient access.

Skills

Specialty pharmacy

Insurance reimbursement

Medical billing

HIPAA knowledge

Communication skills

Education

Associate degree in healthcare administration, business, or a related field

Job description

McKesson is seeking a Cell and Gene Insurance Reimbursement Specialist to support reimbursement for life-changing therapies. This hybrid role requires two days in the office weekly at Cary, NC or Ft. Worth, TX, and demands strong knowledge of insurance processes and medical billing.

You will verify coverage, manage appeals, and collaborate with payers, providers, and patient advocates to improve access while ensuring regulatory compliance. Experience in specialty pharma is essential.