Remote Payor Reimbursement Specialist

Onco360 Oncology Pharmacy; Woodridge (IL); Remote; USD 24,000 - 34,000; Full time

Benefits offered by this job

Medical; Dental; Vision

401k with a match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Company paid benefits - life insurance

Job summary

Onco360 Pharmacy is seeking a Payor Reimbursement Specialist to support day-to-day payer reimbursement activities. The role reports to the Reimbursement Manager and works remotely on a full-time schedule, Monday to Friday, 8:00am–4:30pm.

The position focuses on tracking, communicating, and resolving payor-related issues across locations. Responsibilities include coordinating new payer launches, maintaining contract documents, conveying payer policies to staff, and assisting with credentialing

Qualifications

• Required: Pharmacy or Medical Billing experience, AR or Credential/Contracting.
• Experience with payer contracts and provider enrollment is preferred.
• Knowledge of payor processes and credentialing basics is valued.

Responsibilities

• Participates in new payer launch activities coordinating Reimbursement, Payer Sales and Operations.
• Manage updates and contract documents including Payor Contracting faxes and PBM communications.
• Communicate payer benefit programs and policies to Pharmacy personnel.
• Inform clients about new medication access and handle inquiries.
• Analyze no-go cases to evaluate contracting opportunities.
• Handle payor escalations (AskOps) and manage LOAs with out-of-network providers.
• Assist with Medicaid enrollment, credentialing, and licensing as needed.

Skills

Interpersonal skills

Negotiation

Communication skills

Research

Time management

Detail oriented

Prioritization

Education

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

Job description

Onco360 Pharmacy is seeking a Payor Reimbursement Specialist to support day-to-day payer reimbursement activities. The role reports to the Reimbursement Manager and works remotely on a full-time schedule, Monday to Friday, 8:00am–4:30pm.

The position focuses on tracking, communicating, and resolving payor-related issues across locations. Responsibilities include coordinating new payer launches, maintaining contract documents, conveying payer policies to staff, and assisting with credentialing