Reimbursement Case Manager

TalentBridge

Charlotte (NC)

Remote

USD 37,000 - 42,000

Full time

14 days+

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Job summary

TalentBridge is seeking a dedicated Reimbursement Case Manager for a remote position in North Carolina. This role includes serving as a key point of contact for patients and providers, managing benefits investigations and prior authorizations while providing compassionate support throughout the treatment journey.

Qualifications

Minimum 3+ years of relevant experience in a specialty pharmacy or healthcare setting.
Must have prior case management experience and specialty pharmacy experience.

Responsibilities

Coordinate benefits investigations, prior authorizations, and appeals.
Serve as a single point of contact and advocate for patients and providers.
Manage case loads effectively and provide exceptional customer service.

Skills

Communication

Detail-oriented

Customer Service

Problem-solving

Education

Bachelor’s degree

Tools

MS Word

Excel

Job description

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

Position Summary

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.

Primary Responsibilities

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.

Qualifications

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: