Senior Reimbursement & Access Manager

Caremetx-LL; United States; In loco; USD 55.000 - 90.000; Tempo pieno

Descrizione del lavoro

CareMetx is seeking a Sr. Reimbursement Case Manager to manage patient access and reimbursement workflows. You will coordinate with patients, providers, and specialty pharmacies to support benefits investigations, prior authorizations, and case triage while ensuring HIPAA compliance.

The role emphasizes customer service excellence, collaborative problem-solving, and handling a regional caseload with extensive travel as needed to support payer navigation and provider engagements.

Competenze

• 3+ years of experience in a physician’s office, healthcare setting, and/or insurance background preferred.
• Bachelor’s Degree Preferred.
• Knowledge of HIPAA regulations and HIPAA compliant at all times.

Mansioni

• Serve as a single point of contact for providers, patients and product/sales team.
• Handle escalated accounts and issues.
• Coordinate access to therapies and follow up.
• Facilitate prior authorization support and appeals as needed.
• Provide exceptional customer service to internal and external customers; escalate complaints accordingly.
• Maintain regular and reliable attendance and professionalism.

Conoscenze

Verbal communication

Written communication

Multi-tasking

Adaptability

MS Word

MS Excel

HIPAA knowledge

Organizational skills

Teamwork

Formazione

Bachelor’s degree preferred

Descrizione del lavoro

CareMetx is seeking a Sr. Reimbursement Case Manager to manage patient access and reimbursement workflows. You will coordinate with patients, providers, and specialty pharmacies to support benefits investigations, prior authorizations, and case triage while ensuring HIPAA compliance.

The role emphasizes customer service excellence, collaborative problem-solving, and handling a regional caseload with extensive travel as needed to support payer navigation and provider engagements.