Reimbursement Case Manager Job Concord North Carolina USA,Healthcare

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This range is provided by Talent Bridge. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$18.00/hr - $20.00/hr

Job Title:
Reimbursement Case Manager
Location: Remote (Candidates must reside in North or South Carolina)
Schedule: 11:00 AM - 8:00 PM EST
Type: Contract

Position Summary

We are seeking a dedicated and compassionate Reimbursement Case Manager to join our fully remote team. In this role, you will serve as a key point of contact for patients, healthcare providers, and pharmacies, supporting access to therapies and ensuring a seamless patient experience. You will coordinate benefits investigations, prior authorizations, appeals, and patient assistance programs, advocating for patients throughout their treatment journey.

Primary

Responsibilities

Serve as a single point of contact and advocate for patients and providers, always demonstrating compassion and professionalism.
Support patients in accessing therapy and appropriate support services, including coordinating benefits and reimbursement activities.
Manage case loads effectively in alignment with program requirements.
Collect and review patient information, ensuring completeness and accuracy.
Guide physician office staff and patients on completing and submitting program applications.
Determine patient eligibility and conduct enrollment activities for patient assistance and copay programs.
Perform reimbursement activities such as benefits investigations, prior authorizations, and appeals.
Provide exceptional customer service, resolving inquiries in a timely and accurate manner.
Maintain regular phone contact with patients, providers, payers, and pharmacies.
Provide reimbursement information and support to providers and/or patients.
Report adverse events in compliance with applicable guidelines.
Collaborate with internal team members as needed to ensure optimal case resolution.
Work within defined standard operating procedures and exercise sound judgment.
Follow all HIPAA regulations and company policies.
Other duties as assigned.

Qualifications

Experience and Education Requirements:

Must have prior case management experience.
Must have experience working in a specialty pharmacy setting.
Must have experience with medical reimbursement processes (e.g., benefits investigations, prior authorizations, appeals).
Minimum 3+ years of relevant experience in a specialty pharmacy, medical insurance, reimbursement hub, physician’s office, or healthcare setting.
Bachelor’s degree preferred.

Skills and Competencies:

Excellent verbal and written communication skills.
Ability to multi-task and adapt to changing priorities.
Strong keyboard and computer skills; proficiency in MS Word and Excel.
In-depth understanding of HIPAA regulations.
High attention to detail and strong organizational skills.
Strong interpersonal and customer service skills.
Knowledge of pharmacy and medical benefits.
Understanding of commercial and government payer systems preferred.
Ability to work independently and as part of a team.
Problem-solving mindset and commitment to customer satisfaction.

Physical Demands

General office requirements applicable to a remote work environment.

If you have a passion for helping patients navigate complex healthcare systems and meet the required experience, we encourage you to apply today!

Seniority level

Seniority level Associate

Employment type

Employment type

Contract

Job function

Job function

Customer Service and Health Care Provider
Industries Pharmaceutical Manufacturing

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