Reimbursement Specialist

3 weeks ago

Ontario, Canada Bayshore HealthCare Full time

The Bayshore Specialty Rx Bilingual Reimbursement Specialist will provide reimbursement support to patients and physicians in collaboration with the Nurse Case Manager throughout the entire patient support program journey. This role is operated remotely.



Works with Nurse Case Manager to gather all pertinent and appropriate information to complete all necessary insurance forms (Private and/or Public) in a concise, organized, and professional manner
Troubleshoot any filling/billing issues as required
Adhere to Bayshore Policies and Procedures
Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System as well as key performance indicators for the program.
Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns.
Maintain confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnel
Minimum 2 years of Canadian public and private reimbursement navigation and advocacy experience, within a patient program environment, ideally with PA/SA drugs or chronic diseases is preferred
Understanding of provincial and private coverage criteria
Familiarity with the Special Authorization process for both public and private insurance.
Experience in immunology considered an asset
Understanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape.
Experience in identifying and reporting adverse events to health Canada and Medical Information
Excellent computer skills; Microsoft Suite of products (minimum intermediate level Excel, Word, Power Point)
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