- Experience Level
- Experienced (non-manager)
CEG03D – Reimbursement Specialist
Provide the highest quality of customer service to patients and client representatives, which entails acquiring in depth knowledge of client and marketing requirements. Complete verification of Benefits and Eligibility for all referrals from patients, healthcare providers (HCPs), health plans and pharmaceutical manufacturers. Investigation of benefits and eligibility by phone and/or internet to determine coverage choices patient has in starting on therapy.
Specific job duties:
- Review incoming referrals for completeness of and confirm FDA requirements are met. These are typically received via facsimile, Web portal or client partner download.
- Answer all Incoming calls on Hotline quickly and efficiently, evaluate their need and respond or disseminate call to appropriate member of team.
- Follow up and complete verification of Benefits and Eligibility for all referrals from patients, HCPs, health plans and pharmaceutical manufacturers.
- Investigation of benefits and eligibility by phone and/or internet to determine coverage choices patient has in starting therapy.
- 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.
- Effectively manage and work though action item list to ensure it is current and tasks are completed in a timely fashion.
- Maintain accurate and complete documentation of all inquiries.
- Identify and escalate repetitive questions and/or problems so that corrective action can be pursued and expedited.
- Other duties as assigned.
Desired Skills and Qualifications:
- Minimum High School Diploma or GED equivalent required, Bachelor’s Degree preferred
- 3 – 5 years of experience in the insurance, biotechnology, or pharmaceutical industries, customer service 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, 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.
United BioSource Corporation (UBC) is a leading provider of pharmaceutical support services, partnering with life science companies to make medicine and medical products safer and more accessible. Our services support the full lifecycle of medicine and medical products, including development, commercialization, and long-term value and safety.
While UBC offers employment within Patient Support, Nursing, Pharmacy and Corporate, two main focus areas for the company are Clinical Development & Research and Safety & Risk Management. Members of the Clinical Development and Research teams help evaluate study protocol, target study population, recruit physicians and patients, and collect, clean, validate and report data. As a result, sponsors are able to submit findings to regulatory authorities or make a no-go decision in a timely and clear-cut manner. Additionally, our Safety and Risk Management teams develop, deliver, and report evidence to reinforce safe and appropriate product use.
Through our Patient Access services, we help patients begin therapy quickly and remain on therapy, building strong relationships with patients to ensure optimal care.
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