Reimbursement Specialist
3 days ago
POSITION SUMMARY:
Reporting to the Team Lead and/or Manager, the Reimbursement Associate will be primarily responsible for assisting our patients through insurance challenges and available provincial/federal programs to make their medications more affordable. The Reimbursement Navigator will also be responsible for certain aspects as it pertains to patient/care partner enrollment for the provision of reimbursement, scheduling, and drug ordering.
PRIMARY DUTIES AND RESPONSIBILITIES:
- Communicate with patients, prescribers, healthcare professionals and other key players to support patients through their treatment journey.
- Verify and investigate insurance coverage and benefits for patients, including eligibility, co-payments, deductibles, and prior authorizations.
- Gather and document information from patients/caregivers/prescribers in a concise, organized and professional manner.
- Complete, submit and follow-up on requisite paperwork in a timely manner.
- Liase with private and public insurance providers to determine coverage options
- Act as a central liaison for stakeholders such as physicians, nurses, patients, and clinics and provide required updates
- Maintain confidentiality of patient healthcare information
- Keep up to date with changes in insurance coverage and reimbursement policies and communicate these changes to healthcare providers and patients.
- Monitor treatments as well as chart and report on all activities are directed by Physician protocols.
- Provide patient education based on protocols, individually or in groups
- Regular, predictable availability to meet appointment scheduling needs in an efficient and cost-effective manner to provide patients with quick access to necessary therapies.
- Majority of the time, the role will be dedicated towards Reimbursement services
- The Reimbursement Associate will also be assigned other duties and tasks as required from time to time.
QUALIFICATIONS AND SKILLS:
- A college diploma or higher in a healthcare related course is an asset.
- Two or more years of reimbursement navigation experience involving private and public payers is mandatory.
- Two or more years of related pharmacy experience is an asset .
- Experience working with Patient Support Programs is an asset.
- Experience with Kroll Pharmacy Management System is an asset .
- Familiarity with the Special Authorization process for both public and private insurance in assigned territory .
- Proficiency in Microsoft Office Applications (Outlook, Word, Excel) .
- A demonstrated commitment to high professional ethical standards and a diverse workplace .
- Proven ability to work in a team environment and independently.
- Ease with working in a paperless environment.
- Time management skills and the ability to multi-task and adhere to deadlines.
Job Type: Full-time
Pay: $45,000.00-$55,000.00 per year
Benefits:
- Casual dress
- Company events
- Dental care
- Extended health care
- On-site parking
- Paid time off
Application question(s):
- This role will transition to a hybrid model after 3 months. Are you comfortable with that?
- Do you have any experience dealing with public and private insurance provider to secure coverage?
Experience:
- Reimbursement: 1 year (required)
- Speciality pharmacy: 1 year (required)
Work Location: In person
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