Reimbursement Specialist

3 months ago

Markham, Canada Bayshore HealthCare Full time

**About the Role**

The Reimbursement Specialist will provide drug coverage support to physicians and patients, follow up on submissions pertaining to obtaining coverage through private and provincial drug plans, ensure patients have access to their prescribed treatments in a timely manner, act as a resource to physicians who are prescribing medications and provide continuous support for patients for renewals, drug switches and coverage changes.

**A Day in the Life**
- Provide exemplary courteous professional service to all program stakeholders
- Works with Nurse Case Manager(s) to gather all pertinent and appropriate information to complete all necessary insurance forms (Private and/or Public) in a concise, organized, and professional manner
- Represent the patient with private or public insurers to optimize drug coverage and assist with the completion of Special Authorization (SA) and/or Prior Authorization (PA) forms, when applicable.
- Liaise and advocate with insurance providers and provincial governments as necessary to determine coverage options
- Complete insurance appeals as required
- Follow-up and advocate until a decision is received to secure coverage for the patient
- Coordinate with pharmacy drug coverage and dispensing. Troubleshoot any filling/billing issues as required
- Provide ongoing support and assistance to ensure patient adherence
- Identify, report and document Adverse Events as per Pharmacovigilance requirements
- Participate in ongoing internal and/or external continuing education activities
- 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.
- Participate in proactive Health & Safety activities while performing all duties.
- Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns.
- Maintain confidentiality of pharmaceutical partner(s) and corporate information and discusses same only with appropriate Bayshore personnel
- Complete other tasks as requested.

Job Qualification

**What You Bring to the Team**
- Completion of post-secondary education or equivalent
- Minimum 2 years of Canadian public and private reimbursement navigation and advocacy experience, within a patient program environment is an asset
- Understanding of provincial and private coverage criteria is an asset
- Familiarity with PIPEDA and how it applies in a confidential patient environment.
- Understanding of provincial and private coverage criteria, Special Authorization processes and how to navigate the Canadian drug coverage landscape is an asset
- Demonstrated expertise in delivering exceptional customer service and fostering positive relationships with internal and external stakeholders
- Must be fluent in verbal and written communication and interpersonal skills for both English and French (Applicable for provinces/regions with French language service requirements)
- Strong strategic thinking and problem-solving skills
- Ability to multi-task, prioritize and manage time effectively
- Ability to think under pressure
- Excellent computer skills; Microsoft Suite of products (minimum intermediate level Excel, Word, Power Point)
- Ability to work in a quiet working environment with proven ability to work autonomously within a remote/virtual team environment
- Established high speed internet access from home office.

  • Reimbursement Specialist

    5 months ago

    Markham, 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. The Reimbursement Specialist thrives in an environment that emphasizes teamwork, accountability, possesses a deep willingness to serve...

  • Reimbursement Specialist

    6 months ago

    Markham, Canada Bayshore HealthCare Full time

    **About the Role** 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. The Reimbursement Specialist thrives in an environment that emphasizes teamwork, accountability, possesses a deep...

  • Reimbursement Specialist

    5 months ago

    Markham, Canada Bayshore HealthCare Full time

    **About the Role** 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. The Reimbursement Specialist thrives in an environment that emphasizes teamwork, accountability, possesses a deep...

  • Reimbursement Specialist

    6 months ago

    Markham, Canada Bayshore HealthCare Full time

    **About the Role** 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. The Reimbursement Specialist thrives in an environment that emphasizes teamwork, accountability, possesses a deep...

  • Reimbursement Specialist

    4 weeks ago

    Markham, Ontario, Canada Bayshore HealthCare Full time

    About the RoleThe Reimbursement Specialist will play a crucial role in ensuring patients have access to their prescribed treatments in a timely manner. This involves providing drug coverage support to physicians and patients, following up on submissions pertaining to obtaining coverage through private and provincial drug plans, and acting as a resource to...

  • Reimbursement Specialist

    6 months ago

    Markham, Canada Bayshore HealthCare Full time

    **About the Role** The Reimbursement Specialist will provide drug coverage support to physicians and patients, follow up on submissions pertaining to obtaining coverage through private and provincial drug plans, ensure patients have access to their prescribed treatments in a timely manner, act as a resource to physicians who are prescribing this medication...

  • Reimbursement Specialist

    2 months ago

    Markham, Canada Bayshore HealthCare Full time

    **About the Role** Under the supervision of the Team Lead, the Reimbursement Specialist will provide drug coverage support to physicians and patients, follow up on submissions pertaining to obtaining coverage through private and provincial drug plans, ensure patients have access to their prescribed treatments in a timely manner, act as a resource to...

  • Reimbursement Specialist

    6 months ago

    Markham, Canada Bayshore HealthCare Full time

    Job Description About the Role The Reimbursement Specialist will provide drug coverage support to physicians and patients, follow up on submissions pertaining to obtaining coverage through private and provincial drug plans, ensure patients have access to their prescribed treatments in a timely manner, act as a resource to physicians who are...

  • Expert Reimbursement Navigator

    2 weeks ago

    Markham, Ontario, Canada Bayshore HealthCare Full time

    Job SummaryThe Reimbursement Specialist will provide critical support to patients and physicians, ensuring timely access to prescribed treatments. This role will involve navigating private and provincial drug plans, ensuring compliance with insurance requirements, and advocating for patients' interests.About the RoleProvide exceptional customer service to...

  • Bilingual Reimbursement

    6 months ago

    Markham, Canada Bayshore HealthCare Full time

    About the Role Under the supervision of the Associate Program Manager, the Bilingual Reimbursement/Client Care Specialist (CCS) will play an essential role in supporting patients living with a respiratory disease to improve both their health outcomes and quality of life. CCS will provide drug coverage support to physicians and patients, follow up on...

  • Mortgage Specialist

    4 weeks ago

    Markham, Ontario, Canada BMO Full time

    BMO Mortgage Specialist Job DescriptionAt BMO, we're looking for a skilled Mortgage Specialist to join our team. As a Mortgage Specialist, you'll play a crucial role in helping customers achieve their dream of homeownership.Key Responsibilities:Cultivate and build relationships with referral networks to generate new mortgage business and increase BMO's share...

  • Mortgage Specialist

    1 month ago

    Markham, Ontario, Canada BMO Full time

    About the RoleBMO is seeking a highly skilled and motivated Mortgage Specialist to join our team. As a Mortgage Specialist, you will play a critical role in helping customers achieve their dream of home ownership by providing expert guidance and support throughout the mortgage application and processing process.Key ResponsibilitiesBuild and maintain...

  • Insurance Service Specialist

    2 weeks ago

    Markham, Ontario, Canada Gallagher Full time

    Job OverviewThe role of an Insurance Service Specialist at Gallagher involves providing administrative and technical support to Client Solutions Managers. Key responsibilities include setting up and maintaining client files, processing endorsements and mid-term changes to policy, and requesting new business and renewals.About the RoleThis position requires...

  • Inventory Control Specialist

    1 month ago

    Markham, Ontario, Canada Kuehne+Nagel Full time

    Job Title: Inventory Control SpecialistJob Summary:We are seeking a highly skilled Inventory Control Specialist to join our Contract Logistics team at Kuehne+Nagel. As an Inventory Control Specialist, you will be responsible for monitoring inventory accuracy, conducting investigations, and leading physical inventory periodically.Key Responsibilities:Perform...

  • Travel Industry Operations Specialist

    2 weeks ago

    Markham, Ontario, Canada Jacco Tours Inc Full time

    Jacco Tours Inc is seeking a skilled Travel Industry Operations Specialist to join our team. This permanent role requires 35 to 40 hours of work per week and comes with an estimated annual salary of $65,000 to $75,000 depending on experience.About the RoleThe primary responsibilities of this position involve calculating travel costs and accommodations,...

  • Automotive Quality Assurance Specialist

    2 weeks ago

    Markham, Ontario, Canada Hyundai Canada Full time

    About the RoleAt Hyundai Canada, we are seeking a skilled Automotive Quality Assurance Specialist to join our team. As an entry-level role, this position will support our Quality Assurance team in ensuring exceptional quality standards across our entire spectrum of automobiles.Key ResponsibilitiesParticipate in quality investigations, vehicle evaluations,...

  • Aerospace Quality Specialist

    5 months ago

    Markham, Canada Vexos Full time

    **SUMMARY** The Aerospace Quality Specialist reports directly to the VP, Global Quality, Vexos Markham. The Aerospace Quality Specialist is part of the QA group who are responsible for Vexos’ Quality Management System (QMS), the Corrective and Preventative Action program (CAPA), and performance data analysis. The Aerospace Quality Specialist will be...

  • Clinical Nurse Specialist

    2 weeks ago

    Markham, Ontario, Canada Bayshore HealthCare Full time

    At Bayshore HealthCare, we are seeking a highly skilled Clinical Nurse Specialist to join our team. This is a unique opportunity to work with patients and healthcare professionals to provide support and education on various medications.About the RoleThe Clinical Nurse Specialist will play a crucial role in supporting patients with reimbursement support to...

  • Technical Service Specialist

    6 months ago

    Markham, Canada SIR solutions Full time

    An expert in his or her field, the technical service specialist takes care of the repair and replacement of equipment from our offices or by sometimes travelling to our customers (10% of the time). **Overview of your day-to-day life**: - Repair and replace the system and/or peripherals at our customers' premises and internally (clone PC, Toshiba PC, touch...

  • Fire Protection Sales Specialist

    3 weeks ago

    Markham, Ontario, Canada Fire Safety and Protection Full time

    Fire Protection Sales SpecialistWe are seeking a dynamic and driven Fire Protection Sales Specialist to join our team specializing in the sales of fire alarm systems. The ideal candidate will have a strong background in fire protection systems, a deep understanding of the construction industry, and a proven ability to generate and close sales...