Reimbursement Case Manager

Employee Relations Associates, Inc.; Fort Mill (SC); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical insurance

Dental and Vision

Life insurance

Short-term disability

401(k)

Holiday pay

Job summary

TalentBridge is seeking an experienced Reimbursement Case Manager to join a leading national healthcare organization in the field of pharmaceutical patient support services. This role focuses on owning patient cases, navigating complex reimbursement challenges, and ensuring timely access to specialty medications for patients.

The ideal candidate has hands-on case management experience within healthcare reimbursement, with strong knowledge of prior authorizations, appeals, and patient assistance

Qualifications

• 3+ years of experience in healthcare reimbursement, specialty pharmacy, medical insurance, or patient support services preferred.
• Previous experience managing an assigned patient caseload within a pharmaceutical HUB or specialty pharmacy environment strongly preferred.
• Demonstrated experience managing patient cases from enrollment through benefits verification, reimbursement approval, and therapy access.
• Strong knowledge of benefits investigations, prior authorizations, appeals, copay assistance, and patient assistance programs.
• Experience working directly with patients, healthcare providers, pharmacies, and insurance companies.
• Understanding of commercial insurance, Medicare, Medicaid, and specialty medication reimbursement processes.
• Strong organizational skills with the ability to independently manage multiple active patient cases and competing priorities.
• Excellent communication, problem-solving, and patient advocacy skills.
• Experience documenting patient interactions and case progression within a healthcare CRM or case management platform.

Responsibilities

• Manage an assigned caseload of patients, serving as their primary point of contact throughout the reimbursement and therapy access process.
• Coordinate patient enrollment, benefits investigations, prior authorizations, appeals, and financial assistance programs.
• Work directly with patients, healthcare providers, specialty pharmacies, and insurance companies to resolve reimbursement barriers.
• Proactively monitor patient cases, conduct follow-ups, and ensure timely progression toward therapy access.
• Guide patients and physician offices through enrollment applications, insurance requirements, and patient assistance programs.
• Research and resolve complex insurance coverage issues, including prior authorization denials and appeals.
• Maintain accurate case documentation while ensuring compliance with HIPAA regulations and program guidelines.
• Collaborate with internal teams to resolve escalations and deliver exceptional patient support.

Skills

Patient case management

Healthcare reimbursement

Communication skills

Organizational skills

Job description

Reimbursement Case Manager – Specialty Pharmacy / Patient Support

Location: Remote
Industry: Healthcare | Specialty Pharmacy | Patient Support Services
Employment Type: Full-Time

Are You an Experienced Reimbursement Case Manager Who Is Passionate About Helping Patients Access Life-Changing Therapies?

TalentBridge is seeking experienced Reimbursement Case Managers to join a leading national healthcare organization specializing in pharmaceutical patient support services.

We are looking for candidates with true patient case management experience, preferably within a pharmaceutical HUB, specialty pharmacy, or patient support program.

This is an excellent opportunity for healthcare professionals who enjoy taking ownership of individual patient cases, navigating complex reimbursement challenges, and working directly with patients, providers, and insurance companies to ensure timely access to specialty medications.

What You'll Be Doing

• Manage an assigned caseload of patients, serving as their primary point of contact throughout the reimbursement and therapy access process.
• Coordinate patient enrollment, benefits investigations, prior authorizations, appeals, and financial assistance programs.
• Work directly with patients, healthcare providers, specialty pharmacies, and insurance companies to resolve reimbursement barriers.
• Proactively monitor patient cases, conduct follow-ups, and ensure timely progression toward therapy access.
• Guide patients and physician offices through enrollment applications, insurance requirements, and patient assistance programs.
• Research and resolve complex insurance coverage issues, including prior authorization denials and appeals.
• Maintain accurate case documentation while ensuring compliance with HIPAA regulations and program guidelines.
• Collaborate with internal teams to resolve escalations and deliver exceptional patient support.

What We're Looking For

We are specifically seeking candidates with hands-on case management experience, not solely traditional call center or customer service backgrounds.

• 3+ years of experience in healthcare reimbursement, specialty pharmacy, medical insurance, or patient support services preferred.
• Previous experience managing an assigned patient caseload within a pharmaceutical HUB or specialty pharmacy environment strongly preferred.
• Demonstrated experience managing patient cases from enrollment through benefits verification, reimbursement approval, and therapy access.
• Strong knowledge of benefits investigations, prior authorizations, appeals, copay assistance, and patient assistance programs.
• Experience working directly with patients, healthcare providers, pharmacies, and insurance companies.
• Understanding of commercial insurance, Medicare, Medicaid, and specialty medication reimbursement processes.
• Strong organizational skills with the ability to independently manage multiple active patient cases and competing priorities.
• Excellent communication, problem-solving, and patient advocacy skills.
• Experience documenting patient interactions and case progression within a healthcare CRM or case management platform.

Why Join Us?

You’ll have the opportunity to support a leading healthcare organization dedicated to helping patients overcome financial and insurance barriers to accessing critical specialty medications.

This position offers the opportunity to utilize your reimbursement expertise, build meaningful relationships with patients and providers, and make a direct impact on patient access to care.

Interested? Let's Connect!

If you have experience managing patient cases within a pharmaceutical HUB, specialty pharmacy, or reimbursement support program, we would love to hear from you!

TalentBridge employees are eligible for many benefit offerings such as medical, dental, vision, life insurance, short term disability, 401(k) and holiday pay!

Reimbursement Case Manager – Specialty Pharmacy / Patient Support

Location: Remote
Industry: Healthcare | Specialty Pharmacy | Patient Support Services
Employment Type: Full-Time

Are You an Experienced Reimbursement Case Manager Who Is Passionate About Helping Patients Access Life-Changing Therapies?

TalentBridge is seeking experienced Reimbursement Case Managers to join a leading national healthcare organization specializing in pharmaceutical patient support services.

We are looking for candidates with true patient case management experience, preferably within a pharmaceutical HUB, specialty pharmacy, or patient support program.

This is an excellent opportunity for healthcare professionals who enjoy taking ownership of individual patient cases, navigating complex reimbursement challenges, and working directly with patients, providers, and insurance companies to ensure timely access to specialty medications.

What You'll Be Doing

• Manage an assigned caseload of patients, serving as their primary point of contact throughout the reimbursement and therapy access process.
• Coordinate patient enrollment, benefits investigations, prior authorizations, appeals, and financial assistance programs.
• Work directly with patients, healthcare providers, specialty pharmacies, and insurance companies to resolve reimbursement barriers.
• Proactively monitor patient cases, conduct follow-ups, and ensure timely progression toward therapy access.
• Guide patients and physician offices through enrollment applications, insurance requirements, and patient assistance programs.
• Research and resolve complex insurance coverage issues, including prior authorization denials and appeals.
• Maintain accurate case documentation while ensuring compliance with HIPAA regulations and program guidelines.
• Collaborate with internal teams to resolve escalations and deliver exceptional patient support.

What We're Looking For

We are specifically seeking candidates with hands-on case management experience, not solely traditional call center or customer service backgrounds.

• 3+ years of experience in healthcare reimbursement, specialty pharmacy, medical insurance, or patient support services preferred.
• Previous experience managing an assigned patient caseload within a pharmaceutical HUB or specialty pharmacy environment strongly preferred.
• Demonstrated experience managing patient cases from enrollment through benefits verification, reimbursement approval, and therapy access.
• Strong knowledge of benefits investigations, prior authorizations, appeals, copay assistance, and patient assistance programs.
• Experience working directly with patients, healthcare providers, pharmacies, and insurance companies.
• Understanding of commercial insurance, Medicare, Medicaid, and specialty medication reimbursement processes.
• Strong organizational skills with the ability to independently manage multiple active patient cases and competing priorities.
• Excellent communication, problem-solving, and patient advocacy skills.
• Experience documenting patient interactions and case progression within a healthcare CRM or case management platform.

Why Join Us?

You’ll have the opportunity to support a leading healthcare organization dedicated to helping patients overcome financial and insurance barriers to accessing critical specialty medications.

This position offers the opportunity to utilize your reimbursement expertise, build meaningful relationships with patients and providers, and make a direct impact on patient access to care.

Interested? Let's Connect!

If you have experience managing patient cases within a pharmaceutical HUB, specialty pharmacy, or reimbursement support program, we would love to hear from you!

TalentBridge employees are eligible for many benefit offerings such as medical, dental, vision, life insurance, short term disability, 401(k) and holiday pay!