Patient Access Reimbursement Case Manager

CareMetx, LLC; United States; On-site; USD 48,000 - 70,000; Full time

Job summary

CareMetx, LLC in the United States seeks a Reimbursement Case Manager to support patient access programs and reimbursement workflows. You will handle inquiries, coordinate enrollment, and document actions in the secure CareMetx Connect system.

The role requires collaboration with patients, providers, pharmacies, and manufacturers, with emphasis on accuracy, empathy, and HIPAA compliance.

Qualifications

• 3+ years in specialty pharmacy or reimbursement hub.
• Bachelor's degree preferred.

Responsibilities

• Acts as a single point of contact for providers and patients.
• Coordinates access to therapies and follows up with patients.
• Validates completeness of information and assists with program applications.
• Determines patient eligibility and enrollment activities (e.g., patient assistance programs).
• Performs reimbursement activities such as benefit investigations and prior authorizations.
• Provides exceptional customer service and resolves requests promptly.
• Maintains frequent contact with patients, providers, and pharmacy staff.
• Documents interactions in CareMetx Connect in compliance with HIPAA.

Skills

Communication skills

Multi-tasking

HIPAA knowledge

Detail oriented

Interpersonal skills

Pharmacy benefits knowledge

Customer service

Education

Bachelor's degree

Tools

MS Word

Excel

Job description

CareMetx, LLC in the United States seeks a Reimbursement Case Manager to support patient access programs and reimbursement workflows. You will handle inquiries, coordinate enrollment, and document actions in the secure CareMetx Connect system.

The role requires collaboration with patients, providers, pharmacies, and manufacturers, with emphasis on accuracy, empathy, and HIPAA compliance.