Remote Case Manager, Reimbursement - Evening Shifts

United Biosource Corporation; United States; Remote; USD 65,000 - 75,000; Full time

Job summary

United Biosource Corporation is seeking a Case Manager, Reimbursement for evening shifts. This remote, home-based position supports reimbursement operations from 11:00 AM to 8:00 PM ET, Monday through Friday, with schedules determined by business needs.

The role focuses on prior authorizations, reauthorizations, and appeals, ensuring timely documentation and eligibility for services. Collaboration with patients, providers, and field teams is essential.

Qualifications

• Bachelor’s degree or six years of relevant working experience.
• Two or more years of relevant PBM experience.
• 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.
• Ability to travel as required - remote position with occasional travel.

Responsibilities

• Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required.
• Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders.
• Communicate patient benefits and responsibility timely and accurately.
• Assess and refer patients appropriately for special programs/services when appropriate.
• Performs quality checks on cases and report trends to leadership.
• Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.
• Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders to ensure optimal start to therapy
• Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements.
• Recognize a product quality complaint and forward caller/written information to a manufacturer.
• Other duties, as assigned

Skills

Bachelor's degree

Six years experience

PBM experience

Medical Assistant exp

Microsoft Office

Claims terminology

Communication skills

Critical thinking

Travel flexibility

Education

Bachelor’s degree

Tools

Microsoft Office

Job description

United Biosource Corporation is seeking a Case Manager, Reimbursement for evening shifts. This remote, home-based position supports reimbursement operations from 11:00 AM to 8:00 PM ET, Monday through Friday, with schedules determined by business needs.

The role focuses on prior authorizations, reauthorizations, and appeals, ensuring timely documentation and eligibility for services. Collaboration with patients, providers, and field teams is essential.