Sr. Reimbursement Specialist

University of British Columbia; United States; Remote; USD 42,000 - 64,000; Full time

Benefits offered by this job

Remote opportunities

Competitive salaries

Growth opportunities for promotion

401K with company match

Tuition reimbursement

Flexible work environment

20 days PTO

Paid Holidays

Employee assistance programs

Medical, Dental, and vision coverage

HSA/FSA

Telemedicine (Virtual doctor)

Job summary

University of British Columbia is seeking a Benefits Verification Specialist for a remote, fixed-term assignment to support PBM and MM benefit verifications during the annual re-verification season. The role involves outbound calls to payers, data entry, and coordinating product orders with healthcare providers.

The position emphasizes high-quality customer service, HIPAA-compliant workspace, and working hours Mon-Fri, 9:00 AM–6:00 PM EST, with equipment provided by UBC.

Qualifications

• High School Diploma/GED or equivalent experience required.
• 4–6 years’ experience in the insurance, biotechnology, or pharmaceutical industries; customer service and/or reimbursement.
• MS Office proficiency with database experience a plus.
• Excellent written and verbal communication skills for interactions at all levels.
• Ability to manage multiple priorities and meet deadlines.
• Detail oriented with strong analytical skills.
• Knowledge of third party billing, coding, medical terminology, prior authorizations and appeals preferred.

Responsibilities

• Conduct benefit investigations, verify insurance benefits for patients and physicians’ offices; obtain prior authorizations as required by payer.
• Enter and maintain data in the client database; monitor outstanding items on each client file.
• Participate in conference calls with Client Sales Representatives and physician offices to discuss case status.
• Coordinate product orders, shipment, and therapy initiation with pharmacy and patient.
• Respond to calls from patients, insurance companies, physicians, Sales Reps, pharmacies and homecare agencies; may serve as single contact for assigned prescribers.
• Identify and report REMS-related events to ensure proper safety communications.
• Educate patients and prescribers on program requirements and facilitate referrals.

Skills

Verbal communication

Written communication

Attention to detail

Multi-tasking

Insurance industry knowledge

Time management

Education

High School Diploma/GED or equivalent experience

Tools

MS Office

Database experience

Job description

This position is offered fully Home based (Remote)

As a pharmaceutical support industry leader, UBC is devoted to empowering health solutions for a better tomorrow. We take pride in improving patient outcomes and advancing healthcare. At UBC we provide services to enhance the entire drug development process and commercialization lifecycle - From clinical trial support to real-world evidence generation.

Embark on a rewarding career journey with UBC! Grow your career while making a meaningful impact on the world around you. UBC fosters a culture built on our Core Values being: Collaborative, Conscientious, Curious, Consultative, and Compassionate. We believe in an inclusive workplace that fosters creativity.

If you are seeking a career that will challenge, inspire, and reward you, join us at UBC!

The Benefits Verification Specialist is responsible for conducting outbound calls to insurance payers to complete Pharmacy Benefit Manager (PBM) and Medical Management (MM) benefit verifications, with no inbound call responsibilities. This is a fixed-term assignment supporting the annual re-verification season, running from November 16, 2026 through February 27, 2027, and focused on ensuring accurate coverage and benefit information for program participants.

Project length: November 16, 2026 through February 27, 2027. Due to the short-term nature of this project and business needs, scheduled time off cannot be accommodated during the contract period.

Schedule: Monday through Friday, 9:00 AM - 6:00 PM EST. Candidates must be available to work these hours as scheduled; there is no flexibility in the shift.

Remote Work Requirements: Candidates must have a HIPAA-compliant workspace and reliable high-speed internet. UBC will provide all required equipment, including desktop hardware and software.

Brief Summary: The primary goal of this position is to provide high quality customer service, effectively interface with patients, patient’s families, national payers, home cares and medical doctor’s offices to assist patient and medical provider in expediting the process starting the patient on client product, and ensure the highest level of reimbursement is attained for client product. Extensive knowledge in specialized functions with a wide and comprehensive acquaintance with and understanding of both general and specific aspects of the job and their practical application to complex problems and situations ordinarily encountered.

Specific Job Duties

• 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.

Desired Skills And Qualifications

• High School Diploma/GED or equivalent experience
• 4 – 6 years’ experience in the insurance, biotechnology, or pharmaceutical industries; customer service and/or reimbursement. Health Insurance claims or patient accounting experience a plus.
• Computer proficiency in MS Office applications, with database experience a plus.
• Excellent written and verbal communication skills, with demonstrated ability to communicate with others at all levels.
• Ability to manage multiple priorities and meet deadlines.
• Detail oriented with good analytical skills.
• Knowledge of third party billing, coding, medical terminology, prior authorizations and appeals preferred.

Benefits

At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally.

Here Are Some Of The Exciting Perks UBC Offers

• Remote opportunities
• Competitive salaries
• Growth opportunities for promotion
• 401K with company match*
• Tuition reimbursement
• Flexible work environment
• 20 days PTO
• Paid Holidays
• Employee assistance programs
• Medical, Dental, and vision coverage
• HSA/FSA
• Telemedicine (Virtual doctor appointments)
• Wellness program
• Adoption assistance
• Short and long term disability
• Life insurance
• Discount programs

UBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class. We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients.