Remote Oncology Payor Reimbursement Specialist

Onco360 Oncology Pharmacy; Houston (TX); Teletrabalho; USD 33 000 - 44 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical

Dental

Vision

401k match

Paid time off

Paid holidays

Tuition reimbursement

Life insurance

Short-term disability

Long-term disability

Resumo da oferta

Onco360 Oncology Pharmacy is hiring a Payor Reimbursement Specialist to support day-to-day payor reimbursement processes and communications. This remote, full-time role reports to the Reimbursement Manager and collaborates with Reimbursement leadership and the Payer Sales team to serve as the reimbursement liaison for payer account maintenance.

The position requires experience in pharmacy or medical billing, and a Bachelor's degree is preferred.

Qualificações

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

Responsabilidades

• Participates in payor launch activities with 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 directed by Reimbursement leadership.
• Communicate new medication access to managed clients and handle access inquiries.
• Analyze and report on no-go contracts opportunities to management.
• Manage all Operations payor escalations (AskOps).
• Initiate and execute LOAs for out of network providers based on patient need and manage active/expiring LOAs.
• Assist with credentialing, Medicaid enrollment and licensing needs as required by payer or internal team.
• Maintain a positive, professional attitude with Onco360/CareMed employees and clients.
• Perform other tasks as assigned.

Conhecimentos

Interpersonal skills

Communication skills

Negotiation skills

Decision making

Research skills

Formação académica

Bachelor’s degree in Business, Life Sciences, or related field

Descrição da oferta de emprego

Onco360 Oncology Pharmacy is hiring a Payor Reimbursement Specialist to support day-to-day payor reimbursement processes and communications. This remote, full-time role reports to the Reimbursement Manager and collaborates with Reimbursement leadership and the Payer Sales team to serve as the reimbursement liaison for payer account maintenance.

The position requires experience in pharmacy or medical billing, and a Bachelor's degree is preferred.