Reimbursement Specialist

CornerStone is looking for experienced candidate with medical insurance verification or reimbursement experience! This role is a seasonal position, and for the right candidate, can turn into a long term opportunity.

Job Title: Reimbursement Specialist

Location: WORK FROM HOME- FULLY REMOTE - EQUIPMENT PROVIDED

Applicant must reside in TX, NC, AZ or FL to be considered for this role

Start Date: June 26th

Pay: $18-21/hr.*Based on Experience

Schedule: 8am - 5pm, 9am to 6pm, 10am to 7pm > must be able to work all shifts

Typically Monday to Friday position, but candidate must be flexible to work Saturday's if needed

Job Description:

Under the general supervision of the operational program leadership, the Reimbursement Case Manager is responsible for customer service and case management. The Reimbursement Case Manager will work interactively with patients, healthcare providers, pharmacies, and manufacturer clients. The team will also support
 various reimbursement and patient assistance functions. The Reimbursement Case Manager responds to all patient, and provider account inquiries. Documents all interactions into the CareMetx Connect system in compliance with HIPAA regulations.

Duties and Responsibilities

• Acts as a single point of contact and voice for all providers and patients. Works as a patient advocate and always demonstrates compassion 

• Serves as a patient advocate and enhances the caller/contact experience

• Coordinates access to therapies, conducts appropriate follow up and facilitates access to appropriate support services

• Manages case load depending on the parameters of the program

• Collects and review all patient information, to the degree authorized by the SOP of the program

• Validates completeness of all required information and provides assistance to provider and/or patient

• Provide guidance to physician office staff and patients on how to complete and submit all necessary program applications in a timely manner

• Determines patient’s eligibility and conducts patient enrollment activities (example patient assistance programs and copay assistance)

• Performs reimbursement related activities such as benefit investigations, prior authorizations, appeals, etc.

• Provide exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly

• Maintain frequent phone contact with patients, provider representatives, third party customer service representatives and pharmacy staff

• Provides reimbursement information to providers and/or patients

• Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)

• Coordinate with inter-departmental associates as necessary

• Work on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercise judgment within defined standard operating procedures to determine appropriate action

• Typically receives little instruction on day-to-day work, general instructions on new assignments

• Extensive knowledge of HIPAA regulations and follows all company policies

• Perform related duties as assigned 

Requirements:

• REQUIRED: Previous 3+ years of experience in a specialty pharmacy, medical insurance, reimbursement hub experience, physician’s office, healthcare setting, and insurance background preferred

• Bachelor’s Degree Preferred

Application Process includes:

• Background check

• Virtual interview

• Basic clerical assessments 30+WPM

We are hiring 12 Customer Service Agents to start 6/26 for our Medical Reimbursement Call Center Role and offers are going out asap! WORK FROM HOME!

To Apply for this Job:

Click the Apply Online button, then:

• If you are currently registered with CornerStone Staffing, click the Log In button to add yourself as a candidate to this job.

• If you are NOT currently registered with CornerStone Staffing, click the Create Account button to complete the application.

After completing the online application, for immediate consideration, you will need to email richardson.resume@cornerstonestaffing.com to schedule a phone interview with a recruiter and put "Reimbursement Specialist" in the subject line of your email.

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