Bilingual (Spanish) - Case Manager, Reimbursement

United Biosource Corporation

114d

About The Position

At UBC, the Reimbursement Case Manager serves as a patient advocate, removing barriers for patients accessing specialty pharmaceuticals. As the single point of contact you will provide inbound and outbound phone support to patients, caregivers, and providers to collaboratively determine patient eligibility. In addition to prioritizing and enhancing the patient experience, the reimbursement case manager will coordinate the patient's access to therapies, conduct the appropriate follow ups, and facilitate access to support services such as co-pay assistance programs and patient assistance programs (PAP).

Requirements

• Bachelor’s degree or six years of relevant working experience.
• Two (2) or more years of relevant experience in pharmacy benefit management preferred.
• Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred.
• Proficient in Microsoft Office applications.
• Knowledge of medical and claims processing terminology.
• Excellent written/verbal communication to include providing clear instructions.

Responsibilities

• Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required.
• Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders.
• Communicate patient benefits and responsibility timely and accurately.
• Assess and refer patients appropriately for special programs/services when appropriate.
• Perform quality checks on cases and report trends to leadership.
• Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.
• Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy.
• Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements.
• Recognize a product quality complaint and forward caller/written information to a manufacturer.
• Other duties, as assigned.

Benefits

• Remote opportunities
• Competitive salaries
• Growth opportunities for promotion
• 401k with company match
• Tuition reimbursement
• Flexible work environment
• 20 Days PTO Annually (accrued)
• Paid Holidays
• Employee assistance programs
• Medical, Dental, and vision coverage
• HSA/FSA
• Telemedicine (Virtual doctor appointments)
• Wellness program
• Adoption assistance
• Short term disability
• Long term disability
• Life insurance
• Discount programs

What This Job Offers

• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees