(Contract) Case Manager, Access Solutions & Patient Services- (Portland OR South San Francisco)
About The Position
The Access Solutions Case Manager (CM) acts as a liaison between patients, providers, distributors, and insurance carriers to assure services are provided in the least restrictive and least costly manner. They are responsible for providing reimbursement support to patients, pharmacists, physicians, and internal sales force, educating and assisting patients (and/or their families) and providers to navigate through the reimbursement and appeal process for the assigned product. They also identify barriers to reimbursement, facilitate referrals to alternative coverage options and financial assistance programs for patients who are under insured or require copy assistance.
Requirements
- Bachelor's degree is preferred.
- 3 years of reimbursement experience preferred.
- Knowledge of the managed care industry, including government payers.
- Proficient in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules).
- Understands reimbursement/funding resources and how to access these resources.
Responsibilities
- Demonstrate effective problem-solving skills and excellent customer service.
- Exhibit proficient investigational and analytical abilities with strong written and verbal communication.
- Ability to work collaboratively in a team, effectively delegate tasks, and demonstrate leadership.
- Strong attention to detail, multi-tasking, organizational skills, and effective time management.
- Ability to work under pressure, prioritize tasks, and follow written Standard Operating Procedures.
- Prepared for periodic mandatory overtime, including weekends, during high referral seasons or unexpected volume surges.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
