Remote Reimbursement Specialist - Enhance Patient Access

UBC; Idaho; Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Remote opportunities

Growth opportunities for promotion

401K with company match

Flexible work environment

Paid Holidays

Employee assistance programs

Medical, Dental, and vision coverage

HSA/FSA

Wellness program

Adoption assistance

Short term disability

Long term disability

Life insurance

Job summary

UBC, a pharmaceutical support leader, seeks a Sr. Reimbursement Specialist for a remote US assignment to support reverification season.

You will coordinate insurance benefits verification, prior authorizations, and data entry to expedite patient access to client products while ensuring optimal reimbursement. The role requires 4–6 years in insurance/pharma, strong MS Office skills, and the ability to manage multiple priorities in a fast-paced environment.

Qualifications

• High school diploma or GED required.
• 4–6 years’ experience in insurance, biotechnology, or pharmaceutical industries.
• Experience with health insurance claims or patient accounting a plus.
• Proficient in MS Office; database experience a plus.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and deadlines.
• Knowledge of third party billing, coding, medical terminology, prior authorizations and appeals preferred.

Responsibilities

• Conduct benefit investigations, verify insurance benefits for patient and physicians’ offices, and submit and obtain prior authorizations as required by payer; obtain recertification for cases requiring extended treatment/coverage beyond the expiration of original approval.
• Accurately enter and maintain data as required in client database and patient files and utilize the client database to monitor outstanding items on each client case file. Ensure files are complete so team can determine the current status.
• Participate in conference calls as needed with Client Sales Representatives, client management and physicians’ offices regarding status of cases, drug orders and status of alternative funding.
• Provide coordination of order for product, shipment of product, and therapy initiation with pharmacy and patient.
• Participate in Call Center Activities, triage and respond to incoming calls from patients, insurance companies, physicians, Sales Reps, pharmacies and homecare agencies. May serve as single point of contact for an assigned group of prescribers.
• Identify and report events as required by the REMS requirements for specified medication. Recognize adverse event, product quality complaint, potential risk events, and forward information to the appropriate team member for reporting to the manufacturer.
• Educate patients, prescribers, and others regarding program requirements, and facilitate referrals. Maintain good housekeeping techniques, adhering to quality and production standards and comply with all applicable company, state, and federal safety and environmental programs and procedures.

Skills

Customer service

Insurance benefits verification

Prior authorizations

Reimbursement processes

Data entry

MS Office

Communication skills

Education

High School Diploma/GED

Tools

MS Office

Database experience

Job description

UBC, a pharmaceutical support leader, seeks a Sr. Reimbursement Specialist for a remote US assignment to support reverification season.

You will coordinate insurance benefits verification, prior authorizations, and data entry to expedite patient access to client products while ensuring optimal reimbursement. The role requires 4–6 years in insurance/pharma, strong MS Office skills, and the ability to manage multiple priorities in a fast-paced environment.