Job Description

OUR CLIENT IS A HUGE NAME IN THE GLOBAL HEALTHCARE INDUSTRY AND ADDING TO THE TEAM. YOU WILL START WITH A SPECIFIC PHARMACEUTICAL PRODUCT, THEN ADD TO YOUR PORTFOLIO AS YOU GROW.    WORK FROM HOME!   LIVE ANYWHERE IN THE US ATLANTIC COAST REGION.

MUST BE AN EXPERT IN HEALTH INSURANCE BILLING & REIMBURSEMENT.  KEY RESPONSIBILITIES: Provide virtual and on-demand education for the doctor's office staff in regard to Reimbursement challenges and support services that are available. Office interaction will include:

EDUCATE:

• Benefit Investigation / Prior Authorization Process
• Support Center Services
• Medicare and Commercial coverage
• Educate on the patient communication streams

REIMBURSEMENT SUPPORT:

• Case management
• Billing and coding updates
• Appropriate claims submission
• Specialty Pharmacy
• Medical Benefit Interpretation
• Understanding medical necessity
• Claims / Appeal assistance
• Information related to co-pay assistance programs
• Information related to patient assistance programs

RESPONSIBLE for setting up appointments and completing outbound calls to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information.

Monitor program performance for physicians and manufacturer representatives in accordance with expectations.

Research and compile provider / manufacturer representative specific information for reimbursement database.

Utilize internal resources to proactively address areas of opportunity related to the overall customer experience.

Utilize performance tracking tools & survey

MINIMUM REQUIREMENTS

• BA degree in Business or Healthcare or a minimum of 8 years healthcare related reimbursement experience and 2 years as a field /territory reimbursement advocate
• Medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
• Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.
• Medicare and commercial insurance coverage experience.
• Deliver and document benefit investigation outcomes and relay status reports on a regular basis.
• Ability to effectively handle multiple priorities within a changing environment.
• Strong Computer literacy
  • Must include PowerPoint
  • Must include Web Meeting experience

THE BEST CANDIDATE FOR THIS ROLE WILL HAVE

• Previous territory experience
• Account management experience
• Excellent Interpersonal skills verbal and written
• Sense of customer advocacy
• Not a sales job!

Interviewing immediately for an early March start date. True temp to hire role

Company Description

About RemX- The professional staffing division of EmployBridge, America's Leading Workforce Specialist: When our Talent is looking for their next opportunity, we know they are not just looking for their next paycheck. Our Recruiters are experts in their specialized fields and understand that making the right match between the candidate and the company, is the key to long term success. We are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.