Reimbursement Manager
Amplity Health
full-time
Posted on:
Location Type: Remote
Location: Arizona • Colorado • United States
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Salary
💰 $145,000 - $150,000 per year
About the role
- Guide healthcare providers through the reimbursement process for including prior authorizations, appeals, and benefits verification
- Work with insurance companies, payers, and third-party administrators to address coverage issues and ensure timely access to therapies
- Provide education regarding insurance benefits and financial assistance programs
- Ensure all reimbursement activities comply with federal and state regulations, as well as organizational policies
- Maintain accurate and detailed documentation of all reimbursement activities, including case notes, payer communications, and patient outcomes
- Work closely with cross-functional teams in a compliant manner
- Provide insights to internal teams on reimbursement trends and challenges to inform strategic decision-making
- Educate healthcare providers and internal teams on reimbursement processes, payer requirements, and available patient support programs
- Stay up to date on changes in reimbursement policies and regulations to provide accurate guidance
- Identify systemic issues in the reimbursement process and recommend solutions to improve efficiency and patient outcomes
Requirements
- Bachelor’s degree from an accredited institution required
- A degree with a focus in healthcare administration, business, or a related field advantageous
- A minimum of 3 years of experience in reimbursement, patient access, and or pharmaceutical account management
- Pharmaceutical experience preferred
- Direct experience coordinating with specialty pharmacies preferred
- Knowledge of healthcare reimbursement from a patient and provider perspective including patient access processes, including prior authorizations, coding, and billing and other approaches to pursue coverage
- Understanding how products are covered under benefit design, including government and commercial payer policies
- Familiarity with HIPAA regulations and patient privacy standards
- Strong communication skills
- Skilled with technology tools and programs including Microsoft Office Suite, digital meeting platforms and other CRM platforms
- Successfully pass all required Amplity and client training
- Willingness to work in all US time zones as needed
Benefits
- health, dental, vision
- company-funded disability
- 401K
- generous PTO
- paid holidays
- more
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
reimbursementprior authorizationsappealsbenefits verificationcodingbillingpatient access processespharmaceutical account managementspecialty pharmacieshealthcare reimbursement
Soft Skills
communicationcross-functional collaborationproblem-solvingstrategic decision-makingeducationinsight generationdocumentationcomplianceorganizational skillsadaptability