Remote Reimbursement Case Manager - Specialty Pharma

Medix; Bedford (TX); Hybrid; USD 52,000 - 66,000; Full time

Job summary

Medix is seeking a dedicated Patient Assistance & Co-Pay Reimbursement Case Manager to join our team for a temporary contract project in Bedford, Texas.

You will provide critical financial navigation and case management support for specialty pharmaceutical therapies, working directly with patients, healthcare providers, specialty pharmacies, and hub teams to remove financial barriers and secure access to co-pay savings and PAP funding.

Qualifications

• 2+ years of experience in insurance coordination, prior authorization, or pharmacy benefits.
• Strong working knowledge of pharmacy benefits and payer processes.
• Pharmacy Technicians with payer or PBM experience encouraged to apply.
• Hands-on experience with co-pay programs, patient assistance programs (PAP), or specialty reimbursement.
• A quiet, private, HIPAA-compliant home office workspace.
• Proficiency in basic Microsoft Office programs and case management data entry.
• High School Diploma or GED required.
• Ability to pass a mandatory program credentialing assessment during the assignment.

Responsibilities

• Perform high-volume inbound and outbound calls to patients and healthcare provider offices to deliver real-time updates on benefit investigations, prior authorizations, co-pay card options, and PAP coverage.
• Serve as the primary point of contact for patients and healthcare teams navigating complex insurance processes, free-goods initiatives, and charitable foundation funding.
• Manage a task-based caseload of 20–28 cases daily, accurately reviewing financial documentation, verifying income eligibility, and updating records in real time.
• Evaluate patient financial eligibility and facilitate enrollment into manufacturer co-pay programs, assistance grants, and safety-net solutions.
• Provide professional, compassionate support to patients experiencing stress related to their treatment and financial requirements.
• Maintain complete, audit-ready interaction records within the case management system, adhering to HIPAA guidelines and corporate compliance standards.

Skills

Insurance coordination

Prior authorization

Pharmacy benefits

PAP / co-pay programs

HIPAA compliance

Office software

Education

High School Diploma or GED

Tools

Microsoft Office

Job description

Medix is seeking a dedicated Patient Assistance & Co-Pay Reimbursement Case Manager to join our team for a temporary contract project in Bedford, Texas.

You will provide critical financial navigation and case management support for specialty pharmaceutical therapies, working directly with patients, healthcare providers, specialty pharmacies, and hub teams to remove financial barriers and secure access to co-pay savings and PAP funding.