Payor Reimbursement Specialist — Oncology Billing & Growth

Onco360 Oncology Pharmacy; Louisville (KY); On-site; USD 24,000 - 34,000; Full time

Benefits offered by this job

401k with match

Paid time off & holidays

Tuition reimbursement

Life insurance

Short & long-term disability

Job summary

Onco360 Pharmacy in Louisville, KY is seeking a Payor Reimbursement Specialist to handle day-to-day payor reimbursement processes and communications. Reporting to Reimbursement Manager, this role coordinates with Reimbursement leadership and Payer Sales to support end-to-end payer account maintenance.

The position requires experience in Pharmacy or Medical Billing, AR or Credential/Contracting, with a 3+ year healthcare/medical provider practice background.

Qualifications

• Previous experience in Pharmacy or Medical Billing, AR or Credential/Contracting is required.
• Bachelor’s degree in Business, Life Sciences, or related field is preferred.

Responsibilities

• Participates in payer launch activities ensuring collaboration between Reimbursement, Payer Sales, and Operations teams.
• Manage updates, reviews and contract document maintenance including Payor Contracting faxes, PBM Fax Blasts and emails.
• Communicate payor benefit programs and policies to Pharmacy personnel as needed.
• Inform managed clients about new medication access and handle inquiries.
• Analyze and report on company “No Go's” to evaluate contracting opportunities.
• Manage Operations payor escalations (AskOps).
• Initiate and execute LOAs for out-of-network providers as needed and manage LOAs.
• Assist with credentialing, Medicaid enrollment, and licensing needs as required by payer or internal team.
• Maintain positive professional attitude with Onco360/CareMed employees and clients.
• Perform other tasks as assigned.

Skills

Interpersonal skills

Time management

Decision making

Research

Education

Bachelor’s degree (Business/Life Sciences)

Experience in Pharmacy or Medical Billing

Job description

Onco360 Pharmacy in Louisville, KY is seeking a Payor Reimbursement Specialist to handle day-to-day payor reimbursement processes and communications. Reporting to Reimbursement Manager, this role coordinates with Reimbursement leadership and Payer Sales to support end-to-end payer account maintenance.

The position requires experience in Pharmacy or Medical Billing, AR or Credential/Contracting, with a 3+ year healthcare/medical provider practice background.