Reimbursement Coordinator

This is a Fully Remote Job
About Our Client:
The organization operates in the specialty pharmaceutical sector, focusing on facilitating patient access to necessary therapies by removing barriers related to affordability and adherence. Leveraging expertise in pharmaceutical services, payer systems, and hub operations, the program integrates advanced technologies to streamline patient onboarding and support through a centralized specialty pharmacy, aiming to improve the reach and impact of specialty pharmaceutical products.
About the Opportunity:
The REIMBURSEMENT COORDINATOR plays a vital role in supporting patient access by managing customer service interactions, enrollment processes, and benefit investigations. This position ensures that patients receive individualized care tailored to their financial and insurance situations, directly contributing to patient adherence and therapy success.
Responsibilities:
Serve as the initial point of contact on inbound calls, assessing and addressing needs.
Complete accurate enrollment applications promptly.
Review forms and documentation for completeness and accuracy.
Conduct outbound communications to support patient and program needs.
Resolve patient inquiries and represent patient concerns regarding assistance requests.
Maintain detailed records of all interactions in the appropriate database.
Contact patients/providers to clarify missing information or benefit details.
Assess patients’ financial capacity and guide them to suitable financial assistance.
Document required actions for benefit investigation processing.
Collaborate with team members to support patient population needs.
Manage follow-up on benefit investigation denials, including prior authorizations and appeals.
Monitor payer/plan issues and report relevant updates or trends to management.
Research insurance options and assist patients in selecting appropriate coverage.
Handle escalations per regional guidelines and communicate resolutions within agreed timeframes.
Conduct research to resolve payer, physician, or pharmacy-related issues.
Requirements:
3-6 years of relevant experience preferred.
High school diploma, GED, or equivalent work experience preferred.
Experience in patient support services preferred.
Knowledge of Medicare (A, B, C, D), Medicaid, and commercial payer policies preferred.
Understanding of medical, supplemental, and pharmacy insurance benefits preferred.
1-2 years of experience with prior authorization and appeal submissions preferred.
Ability to work effectively in high-volume, quality-focused teams.
Intermediate to advanced proficiency in Microsoft Office applications.
Previous medical experience preferred.
Adaptability, self-motivation, dependability, and problem-solving skills preferred.
Bilingual abilities preferred.
Pay Range and Compensation Package:
Hourly rate range: $23.10 to $29.61
Bonus eligible: No
Benefits & Perks:
Medical, dental, and vision coverage
Paid time off plan
Health savings account (HSA)
401(k) savings plan
Access to wages before payday with myFlexPay
Flexible spending accounts (FSAs)
Short- and long-term disability coverage
Work-life resources
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.

Skills
Onboarding, Documentation

Experience
3-6 yrs

Work arrangement
Yes