Bilingual Reimbursement Specialist

7 days ago


Mississauga ON LB M, Canada ClaimSecure Full time

Reporting to the Team Lead of Clinical Pharmacists, the Coverage Navigation Specialist is responsible for day-to-day operations supporting the Clinical Services team.

Principal Responsibilities:

  • Receive, handle and follow-up on Coverage Navigation applications
  • Manage all aspects required to obtain prescription drug coverage for patients
  • Maintain communication between internal and external stakeholders
  • Coordinate cases with public and private payers, physician offices, pharmacies, and other relevant healthcare providers in order to maximize reimbursement options
  • Coordinate all documents and related paperwork to private and public payers, as needed
  • Liaise with internal stakeholders for report generation
  • Respond to client inquiries related to Coverage Navigation cases and provide status updates
  • Act as the primary resource of contact for members, internal partners and external clients
  • Maintain high standards of professional practice by adhering to the ethics of the profession and keeping abreast of the latest professional advances
  • Monitor Coverage Navigation cases to ensure goals are met on daily, monthly and quarterly basis
  • Ensure continuity of care for cases is maintained and that any changes in application progress are clearly identified and transitioned accordingly
  • Provide written and verbal communication to members, clients, and internal partners
  • Identify process gaps, develop strategies to overcome operational challenges, and implement new processes as required
  • Assume responsibility for personal and professional development
  • Acquire and maintain extensive knowledge of private and provincial funding

Knowledge, skills and experience:

  • Post-secondary education e.g., BSc and/or RPhT diploma
  • Minimum 2 years' experience working in pharmacy setting
  • Must be bilingual (English/French)
  • Previous experience in pharmacy benefit management, insurance, and/or reimbursement is preferred
  • Solid understanding of provincial and private drug plans for medication access
  • Working knowledge of MS Office Applications – Word, Excel, PowerPoint
  • Ability to organize, coordinate and prioritize own work
  • Demonstrated capacity to liaise in a constructive and collaborative fashion with a variety of healthcare providers, clients and staff at various organizational levels
  • Demonstrated strong ability to effectively communicate (verbal, written and presentation)
  • Excellent analytical and problem-solving skills
  • Demonstrated critical thinking, problem solving skills and attention to detail
  • Demonstrated commitment to collaborative practice and lifelong learning

Employment is contingent upon the successful completion of a background check/police record check.

Job Type: Contract

Contract length: 17 months

Pay: $51,000.00-$56,000.00 per year

Benefits:

  • Wellness program
  • Work from home

Experience:

  • Retail Pharmacy: 2 years (required)

Language:

  • English and French (required)

Work Location: Hybrid remote in Mississauga, ON L5B 1M2



  • Mississauga, Canada Bioventus Full time

    A healthcare solutions company seeks a Customer Service / Medical Reimbursement Specialist in Mississauga, Ontario. The ideal candidate will be bilingual in English and French, with a background in customer care or reimbursement. Responsibilities include managing patient orders, ensuring authorizations, and providing detailed support to sales teams. This...


  • Mississauga, Canada PurposeMed Full time

    **About Affirming Care Pharmacy**: Founded in 2021, Affirming Care Pharmacy is a specialty pharmacy with locations in Calgary, Alberta and Mississauga, Ontario. We have partnered with PurposeMed Inc., a telehealth organization that provides complex healthcare services in HIV prevention and mental health treatment (ADHD, anxiety and depression). Affirming...


  • Mississauga, Canada Bayshore HealthCare Full time

    **ABOUT THIS 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...


  • Mississauga, Canada Bayshore HealthCare Full time

    Under the supervision of the Program Manager, 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...


  • Mississauga, ON LW A, Canada OkRx Full time

    Supports patients and healthcare providers by navigating insurance coverage and reimbursement processes. Responsibilities include verifying benefits, submitting and tracking prior authorizations, appeals, and claims, coordinating with payers and pharmacies, and helping patients access financial assistance programs to ensure timely and affordable access to...


  • Mississauga, Canada Bilingual Source Full time

    Bilingual Credit & Collections Representative (French required) Introduction Our client is currently seeking a Bilingual Credit & Collections Representative fluent in French and English to join their stable and well-established team in Mississauga. This is a full-time, in-office role ideal for someone who values predictability, structure, and the opportunity...


  • Mississauga, Canada Bioventus LLC. Full time

    A medical device company is seeking a Customer Service / Medical Reimbursement Specialist in Mississauga, Ontario. This hybrid role requires proficiency in English with French preferred. Responsibilities include managing customer calls, processing orders, and ensuring accurate reimbursement authorizations. Ideal candidates have a background in medical...


  • Mississauga, Canada Bayer Full time

    At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where ,Health for all, Hunger for none’ is no longer a dream, but a real possibility. We’re doing it with energy, curiosity and sheer dedication, always learning from unique perspectives of those around us, expanding our thinking, growing our...


  • Mississauga, Canada Bayer CropScience Limited Full time

    At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where ,Health for all, Hunger for none’ is no longer a dream, but a real possibility. We’re doing it with energy, curiosity and sheer dedication, always learning from unique perspectives of those around us, expanding our thinking, growing our...


  • Mississauga, Canada Bayer AG Full time

    Select how often (in days) to receive an alert: At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where ,Health for all, Hunger for none’ is no longer a dream, but a real possibility. We’re doing it with energy, curiosity and sheer dedication, always learning from unique perspectives of those around...