Reimbursement Specialist

Job Information

Title: Reimbursement Specialist I

Location: US

:

Category: Administration

Position Type: Full-Time

Remote: Yes

Pay Range: USD $18.67 - USD $21.96 /Yr.

STAR Bonus % (At Risk Maximum): 0.00 - Ineligible

Work Schedule: M-F 10:30AM-7PM

Remote Work Notification: ATTENTION:
Lumicera is unable to offer remote work to residents of Alaska, Connecticut, Delaware, Hawaii, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.

Lumicera

Lumicera Health Services is seeking a Reimbursement Specialist I to join our team! Under direction from the Assoc. Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, the Reimbursement Specialist I is primarily responsible for following standard operating procedures to obtain and process manufacturer copay assistance program reimbursement. The Reimbursement Specialist I shall have knowledge of billing procedures and work to reduce discrepancies, inaccuracy, and outstanding balances.

The Reimbursement Specialist I may also assist in contacting patients with an outstanding balance to communicate billing options.

• Responsible for ongoing monitoring of claims activity for accuracy and successful submission.
• Responsible for ensuring that patient billing information is set up appropriately in the pharmacy software.
• Participate, as necessary, in conferences and meetings related to reimbursement/billing.
• Respond to employee/patient/client questions or complaints regarding reimbursement and/or billing.
• Work with internal teams to review and resolve claim issues.
• Maintain accurate reference information relating to reimbursement and copay assistance.
• Ensure accurate and thorough documentation of information, insurance and prescriptions/orders within the patient profile.
• Act in accordance with all applicable federal and state laws and with the highest ethical standards.
• Other duties as assigned.

• High School Diploma or equivalent GED. Some college preferred.
• CPhT preferred.
• Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure.
• Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred.
• Participate in, adhere to, and support compliance program objectives.
• Consistently interact cooperatively and respectfully with other employees.

• Top of the industry benefits for Health, Dental, and Vision insurance.
• 20 days paid time off.
• 4 weeks paid parental leave.
• 9 paid holidays.
• 401K company match of up to 5% - No vesting requirement.
• Adoption Assistance Program.
• Flexible Spending Account.
• Educational Assistance Plan and Professional Membership assistance.
• Referral Bonus Program - up to $750!

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