Top 2038 Reimbursement manager Jobs in Millvale, Pa

Reimbursement Case Manager
Vanscoy Rare Pharmacy —Coraopolis, PA
- Full-time
- Microsoft Outlook
- Ability to walk for extended periods
- Research
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Reimbursement Case Manager
RareMed Solutions —Coraopolis, PA
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Ability to walk for extended periods
- Health insurance
- Prescription drug insurance
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Supervisor of Mortgage Default Servicing
F.N.B. Corp. —Pittsburgh, PA
- Full-time
- Computer literacy
- Bachelor of Science
- Office
Voice Network and Contact Center Manager
Essential Utilities, Inc. —Pittsburgh, PA
- Full-time
- Hybrid work
- Background check
- Maintenance
- Analysis skills
- Health savings account
- Relocation assistance
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3d
Finance Director
Borough of Dormont —Dormont, PA
- $60,000 - $80,000 a year
- Full-time
- Word processing
- Office
- Finance
- Paid parental leave
- Health insurance
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RN Case Manager
Community LIFE —Wilkinsburg, PA
- $72,000 - $85,000 a year
- Full-time
- Nursing
- RN License
- Word processing
- Travel reimbursement
- Mileage reimbursement
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Purchasing Manager - Design & Build Construction
Marvista Design + Build, LLC —Squirrel Hill, PA
- $50,000 - $70,000 a year
- Full-time
- Construction site
- Mid-level
- Office
- Mileage reimbursement
- Health insurance
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LTD (Long Term Disability) Claim Manager
New York Life —Pittsburgh, PA
- $50,000 - $71,500 a year
- Full-time
- Hybrid work
- Background check
- Microsoft Outlook
- Mid-level
- Free parking
- Disability insurance
Hospice RN Case Managers-$5,000 Sign-on Bonus
Bridges Hospice, Inc —Monroeville, PA
- $74,000 - $80,080 a year
- Full-time
- Management
- RN License
- Customer service
- Mileage reimbursement
- Paid holidays
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Senior Staff Geotechnical Engineer
Langan Engineering & Environmental Services —Pittsburgh, PA
- Full-time
- Construction site
- 3 years
- Master's degree
- Disability insurance
- Health insurance
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Licensed Clinician
The Bridge to Well-Being Counseling Center —Wilkinsburg, PA
- Part-time
- Private practice
- LMFT
- Nursing
- 401(k)
- Tuition reimbursement
Quick Apply
Vocational Rehabilitation Specialist/Case Manager
Hoover Rehabilitation Services, Inc. —Pittsburgh, PA
- Full-time
- LPC
- Mid-level
- Master's degree
- Travel reimbursement
- Health insurance
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Case Manager
Merakey —Penn Hills, PA
- $22.26 an hour
- Full-time
- Clean driving record
- Mid-level
- Driver's License
- Travel reimbursement
- Health insurance
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Admissions RN
VITAS Healthcare —Cranberry Township, PA
- $40 - $42 an hour
- Full-time
- RN License
- Mid-level
- Home health
- Disability insurance
- Health insurance
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Restaurant Manager
Red Lobster —Pittsburgh, PA
- $50,000 - $60,900 a year
- Full-time
- Sales
- ServSafe
- Mid-level
- Health insurance
- Dental insurance
14d
Plant Manager
Latham Pool Products, Inc —Pittsburgh, PA
- Full-time
- Inventory management
- Ability to walk for extended periods
- 3 years
- Health savings account
- AD&D insurance
14d
Process Improvement Engineer – Production & Maintenance
All-Clad Metalcrafters —Canonsburg, PA
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Engineering
- Health savings account
- Health insurance
14d
Senior Crane Technician
Material Handling Systems —Braddock, PA
- $25 - $35 an hour
- Full-time
- Background check
- Pass drug screening
- English
- Paid holidays
- Health insurance
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Warehouse/Logistics/Transportation Supervisor
Stellar Precision Components —Jeannette, PA
- $50,000 - $60,000 a year
- Full-time
- Background check
- Mid-level
- Continuous improvement
- Health insurance
- Dental insurance
Quick Apply
14d
Survey Technician Pittsburgh, PA
Blew & Associates, P.A. —Pittsburgh, PA
- $70,000 - $95,000 a year
- Overtime
- Construction site
- Research
- Mid-level
- Paid parental leave
- Paid holidays
Quick Apply

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reimbursement manager jobs near millvale, pa

Reimbursement Case Manager

Vanscoy Rare Pharmacy
Coraopolis, PA

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Job Details

Full-time

Qualifications

Pharmacy Information Systems (PIS)
Overseeing health insurance pre-certification
Medical software
Medical insurance coverage verification
Caseload management
Employee relationship building
High school diploma or GED
Health insurance referral requirements
Healthcare reimbursement methods

Full Job Description

Purpose:

The Reimbursement Case Manager is a professional client facing role responsible for various functions, functions related to supporting patients, healthcare providers, and business partners with circumstances related to pharmacy reimbursements, including accurate and timely response to client inquiries regarding specific referral status or escalation. The Reimbursement Case Manager serves as a primary point of contact for professional, concise internal and external communication regarding case status updates, next steps in prescription processing, communication of reimbursement issues, etc. The Reimbursement Case Managers will interact directly with external clients such as manufacturers as well as internal teams including Operations and Program Management. The Reimbursement Case Manager will report to the Clinical Pharmacist and Implementation Manager.

Responsibilities:

Serve as primary point of contact and case manager for client and customer inquiries and escalations
Process benefits investigations, benefits verifications, prior authorization submissions, and appeals as necessary to accelerate patient care access
Coordinates services with internal program operations and Program Management
Ability to coordinate and collaborate with manufacturer representatives, HCP offices and other key personnel on complex cases which require prior authorization or appeals support
Manage patient claims for prescription drug and medical benefits in relation to providing excellent specialty pharmacy care
Establish self as regional expert on payer trends, product access, and reporting reimbursement trends and/or delays (i.e. denials, underpayment, access delays, etc.)
Work independently to complete assigned work in accordance with Standard Operating Procedures and defined service levels to complete program enrollment, answer inquiries, and coordinate access to therapies
Process of patient and prescriber requests in order to ensure access to therapy in a timely manner
Use high-level problem-solving skills to research cases independently, using professional judgement to make sound decisions
Maintain frequent phone contact with internal operational staff, external client, and external specialty pharmacies
Provide exceptional, white glove, customer service to internal and external customers; resolves any customer and client requests in a timely and accurate manner; escalates appropriately

Provide support to ensure efficient referral processing from referral intake to triaging of prescription
Independently and effectively resolve complex issues related to pharmacy reimbursement and patient support with creativity and innovation
Strong compliance mindset, demonstrating clear understanding of patient privacy laws
Active participation in building and maintaining respectful, collaborative internal/external team relationships, exercising and encouraging positivity.

Required Qualifications:

High school diploma or equivalent
2+ years of relevant pharmacy reimbursement/insurance experience, including benefit investigation and benefit verification of prescription benefits
2+ years of relevant pharmacy case management experience
1+ years experience as a pharmacy technician
1+ years experience operating in CareTend Pharmacy Management System
Working knowledge of BI/BV process, pharmacy and prescription benefits, prior authorization process, and pharmacy access support solutions
Ability to communicate in a clear, logical, effective, and consistent manner
Ability to independently manage case load, prioritize work, and use time management skills to manage deliverables
Empathy, drive, and commitment to exceptional service

Preferred Qualifications:

Associate’s Degree or Bachelor’s Degree
Understanding of plan types – Government, Commercial, Medicaid, VA, Fed
Possess a strong understanding of biologic/specialty pharma market and patient access challenges

Knowledge of insurance structure (ex PBM’s, major medical plans, co-pay assistance /cards)
Working Knowledge of Third-Party and other Foundation programs
Basic understanding of Co-Pay Assistance (if applicable)
Strong analytical and organizational skills with attention to detail
Excellent verbal and written communication skills
Ability to proficiently use Microsoft Excel, Outlook and Word
Knowledge of Rare Diseases
Experience documenting requirements, creating training materials and working directly with end users
Self-starter with ability to exercise sound independent judgment

Work Environment
This job operates in a professional office environment and teleworking from the employee’s home address listed in their employment file. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. When telecommuting employees must have reliable internet access in order to access required systems and software associated with the position's responsibilities. The amount of time the employee is expected to work per day or pay period will not change as a result of participation in the teleworking program. Employees are responsible for the set-up of their home office environment, including physical set-up, internet connection, phone line, electricity, good lighting, comfortable temperature, furniture, etc. Employee’s teleworking space should be separate and distinct from their “home space” and allow for privacy. Vanscoy Rare Pharmacy expects employees teleworking to be as efficient and professional as if they were in the office. The amount of time spent in office or teleworking is contingent upon the needs/priorities of Vanscoy Rare Pharmacy and will vary based on those needs/priorities.

Physical Demands
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function of the job.

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Refine Your Search

reimbursement manager jobs in millvale, pa

Reimbursement Case Manager

Reimbursement Case Manager

Supervisor of Mortgage Default Servicing

Voice Network and Contact Center Manager

Finance Director

RN Case Manager

Purchasing Manager - Design & Build Construction

LTD (Long Term Disability) Claim Manager

Hospice RN Case Managers-$5,000 Sign-on Bonus

Senior Staff Geotechnical Engineer

Licensed Clinician

Vocational Rehabilitation Specialist/Case Manager

Case Manager

Admissions RN

Restaurant Manager

Plant Manager

Process Improvement Engineer – Production & Maintenance

Senior Crane Technician

Warehouse/Logistics/Transportation Supervisor

Survey Technician Pittsburgh, PA

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