Senior Caseworker, Bilingual

Recruiting.com

Senior Caseworker providing reimbursement support for patients in medical settings. Bilingual in French and English, managing complex insurance and reimbursement tasks with a focus on patient assistance.

Posted 5/5/2026full-timeRemote • 🇨🇦 CanadaSeniorWebsite

About the role

Key responsibilities & impact

Working closely with assigned patients’ to identify various reimbursement coverage options and investigate financial options for those without insurance.
Assist with the coaching and mentoring of existing team members.
Manage a patient caseload larger than their caseworker counterparts.
Be a reimbursement expert in assigned caseload territory.
Provides other caseworker(s) assistance with complex reimbursement, insurance, benefit investigation, special authorization, and appeal requests.
Participate in special projects as assigned by the Program Manager.
Provide daily support to Associate Program Manager(s)
Assist management with various reports and program related tasks.
Work with management to develop program protocol and SOP for Caseworker role.
With management, lead training of new caseworkers, including but not limited to shadowing & call monitoring.
Regularly Interacts with insurance companies, physician' offices, and healthcare professionals to provide optimal reimbursement support
Assists the patient with Clinic and Pharmacy selections, and schedules patient appointments
Generates drug orders ensuring that required information is faxed to the pharmacy, and related parties
Adherence to the general company processes.
Implementing call-centre programs including the provision of patient, healthcare professional and funding bodies with telephone support. Current assistance lines focus on: Funding and access issues, including private, public and special access programs; Compliance programs
Administer and adhere to case-management protocols, including clinical monitoring, data collection, ongoing patient follow-up, compliance, therapy disruption/discontinuation monitoring, adverse event reporting and liaison with primary healthcare providers; Implementing pharmaceutical and biotechnology related market research initiatives with physicians, patients, pharmacists or other allied health professionals; All patient programs are based on casework methods and include a significant amount of out-bound calls.
Document each activity in program specific database.
Participate and attend ongoing refresher training and in specialized training courses for specific products or programs as deemed appropriate by the manager.
Clear communication to manager, pod, and program trained colleagues regarding the management of cases during foreseen absences.
Responsible to report all Adverse Events to the assigned units/departments

Requirements

What you’ll need

A minimum of two (2) years experience in customer service; experience in medical, pharmaceutical and/or insurance industry is an asset
Bilingual in French and English: written and verbal is an asset
Highly organized with strong attention to detail
Strong proficiency in Microsoft applications (Outlook, Word, Excel & PowerPoint)
Flexibility in working shifts (hours of operation are 8 am - 8pm)
Ability to apply critical thinking skills in order to solution problems
A Minimum of 2 years experience working for a patient support program
Experience working in a call center environment an asset
Strong communication and interpersonal skills: written and verbal including effective phone etiquette to diverse audiences i.e. internal, healthcare professionals and patients
Proven ability to manage time, set priorities and multi-task in order to meet various competing work deadlines
Minimum University Degree in a related field or equivalent

Benefits

Comp & perks

medical, dental, and vision care
comprehensive suite of benefits
support for working families
backup dependent care
adoption assistance
infertility coverage
family building support
behavioral health solutions
paid parental leave
paid caregiver leave
variety of training programs
professional development resources
mentorship programs
employee resource groups
volunteer activities
inclusive culture

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

case managementreimbursement expertiseinsurance benefit investigationdata collectionadverse event reportingclinical monitoringpatient follow-upcall center experienceMicrosoft Office Suitebilingual in French and English

Soft Skills

strong attention to detailflexibilitycritical thinkingstrong communication skillsinterpersonal skillstime managementorganizational skillsability to multi-taskcoaching and mentoringeffective phone etiquette

Certifications

University Degree in a related field