Remote Reimbursement Case Manager - Evening Shifts

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

Benefits offered by this job

Remote opportunities

Growth opportunities for promotion

401K with company match

Tuition assistance (after 90 days of就业

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 (after 90 days)

Long term disability

Life insurance

Job summary

UBC is hiring a Case Manager, Reimbursement for evening shifts. This remote, full-time role supports 11:00 AM to 8:00 PM Eastern Time, Monday through Friday. You will oversee caseloads, coordinate prior authorizations and appeals, and communicate benefits to patients and providers.

The role emphasizes collaboration, quality checks, and adherence to safety standards, with opportunities to assist on PAP and co-pay programs as applicable. Remote work in the US is supported.

Qualifications

• Bachelor’s degree or six years of relevant working experience.
• 2+ 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.
• Ability to travel as required - This is primarily a remote position; however, occasional travel may be required based on client, business, or training needs.

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 (internal/external) 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

Excellent written/verbal communication

Critical thinking

Multi-tasking

Travel ability

Microsoft Office

Medical and claims processing terms

Education

Bachelor’s degree or six years of relevant working experience

Tools

Microsoft Office

Job description

UBC is hiring a Case Manager, Reimbursement for evening shifts. This remote, full-time role supports 11:00 AM to 8:00 PM Eastern Time, Monday through Friday. You will oversee caseloads, coordinate prior authorizations and appeals, and communicate benefits to patients and providers.

The role emphasizes collaboration, quality checks, and adherence to safety standards, with opportunities to assist on PAP and co-pay programs as applicable. Remote work in the US is supported.