Remote Case Manager, Reimbursement & Authorization

United-Biosource-Corporation; United States; Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

Remote opportunities

401K with company match

Tuition reimbursement

Flexible work environment

20 Days PTO

Paid Holidays

Employee assistance programs

Medical, Dental, and vision coverage

HSA/FSA

Wellness program

Adoption assistance

Short term disability

Long term disability

Life insurance

Job summary

United-Biosource-Corporation (UBC) is seeking a Case Manager, Reimbursement to provide day-to-day case management oversight for a remote US-based caseload. You will coordinate prior authorizations, reauthorizations and appeals, and be the primary contact for patients, providers, and field reimbursement.

Responsibilities include ensuring timely payer documentation, pre-screens for PAP and injection services, performing quality checks, and escalating complex cases.

Qualifications

• Bachelor’s degree or six years of relevant working experience.
• Two or more years of relevant experience in pharmacy benefit management preferred.
• Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred.
• Certification preferred but not required.
• Proficient in Microsoft Office applications.
• Knowledge of medical and claims processing terminology.
• Excellent written/verbal communication to include providing clear instructions.
• Must possess a strong critical thinking skillset along with the ability to multi-task.

Responsibilities

• Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely.
• Act as single point of contact for prior authorization and appeal processing communications.
• Communicate patient benefits and responsibility timely and accurately.
• Assess and refer patients for special programs/services when appropriate.
• Performs quality checks on cases and report trends to leadership.
• Adhere to safety and environmental programs and procedures.
• Troubleshoot complex cases and coordinate with internal/external stakeholders.
• Report Adverse Drug Events as required.
• Forward product quality concerns to manufacturers.
• Other duties as assigned.

Skills

communication

critical thinking

multi-tasking

medical terminology

Education

Bachelor’s degree or six years of relevant experience

Tools

Microsoft Office

Job description

United-Biosource-Corporation (UBC) is seeking a Case Manager, Reimbursement to provide day-to-day case management oversight for a remote US-based caseload. You will coordinate prior authorizations, reauthorizations and appeals, and be the primary contact for patients, providers, and field reimbursement.

Responsibilities include ensuring timely payer documentation, pre-screens for PAP and injection services, performing quality checks, and escalating complex cases.