We’re looking for a detail‑oriented Reimbursement Case Manager to support patients in accessing their prescribed therapies. This role involves navigating insurance processes, coordinating benefits, and ensuring timely approvals for treatment.
Key Responsibilities
Conduct benefit investigations for medical and pharmacy coverage.
Facilitate prior authorizations, step edits, and appeals.
Communicate with payers, providers, and patients to resolve access issues.
Maintain accurate records in compliance with program standards.
Escalate complex cases as needed, following program protocols.
Monitor and report changes in reimbursement policies and access barriers.
Understand patient health conditions relevant to the program.
Uphold confidentiality and ethical standards at all times.
Required Skills & Experience
2+ years of experience in reimbursement, patient services, or case management.
Strong knowledge of Medicare, Medicaid, VA, DoD, and commercial insurance plans.
Experience with pharmacy and medical benefit processes.
Proficient in Salesforce and Quick Path platforms.
Comfortable with outbound calls to payers, providers, and patients.
Prior experience in a hub or contact center environment is a plus.
Preferred Qualifications
Familiarity with pharmaceutical benefit workflows.
Experience working with field sales or reimbursement teams.
Ability to handle inbound transfers and third‑party consent processes.
Strong communication and organizational skills.
Pay and Benefits
Pay range: $20.00 - $22.00/hr.
Medical, dental & vision.
Critical illness, accident, and hospital.
401(k) Retirement Plan – pre‑tax and Roth post‑tax contributions available.
Life insurance (voluntary life & AD&D for employee and dependents).
Short and long‑term disability.
Health Spending Account (HSA).
Transportation benefits.
Employee Assistance Program.
Time off/leave (PTO, vacation or sick leave).
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Oct 31, 2025.
Equal Employment Opportunity
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.