Case Manager, Reimbursement – Bilingual, Spanish
UBC
full-time
Posted on:
Location Type: Remote
Location: Montana • United States
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About the role
- Serve as a patient advocate, removing barriers for patients accessing specialty pharmaceuticals.
- Provide inbound and outbound phone support to patients, caregivers, and providers to collaboratively determine patient eligibility.
- Coordinate the patient's access to therapies, conduct appropriate follow-ups, and facilitate access to support services such as co-pay assistance and patient assistance programs (PAP).
- Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely.
- Act as single point of contact responsible for prior authorization and appeal processing communications.
- Communicate patient benefits and responsibility timely and accurately.
- Assess and refer patients appropriately for special programs/services when needed.
- Perform quality checks on cases and report trends to leadership.
- Trouble shoot complex cases while interfacing with key stakeholders.
- Report Adverse Drug Events experienced by the patient in accordance with pharmaceutical requirements.
Requirements
- Bachelor’s degree or six years of relevant working experience
- Two (2) or more years of relevant experience in pharmacy benefit management preferred
- Bilingual in English and Spanish (verbal and written) required.
- Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred
- Proficient in Microsoft Office applications
- Knowledge of medical and claims processing terminology
- Excellent written/verbal communication to include providing clear instructions
Benefits
- Remote opportunities
- Competitive salaries
- Growth opportunities for promotion
- 401k with company match*
- Tuition reimbursement
- Flexible work environment
- 20 Days PTO Annually (accrued)
- Paid Holidays
- Employee assistance programs
- Medical, Dental, and vision coverage
- HSA/FSA
- Telemedicine (Virtual doctor appointments)
- Wellness program
- Adoption assistance
- Short term disability
- Long term disability
- Life insurance
- Discount programs
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
pharmacy benefit managementmedical terminologyclaims processingcase managementprior authorizationappeal processingquality checkspatient assistance programsco-pay assistanceadverse drug events reporting
Soft Skills
patient advocacycommunicationcollaborationtroubleshootingorganizationattention to detailproblem-solvinginterpersonal skillsleadershipfollow-up
Certifications
Bachelor's degreeMedical Assistant certificationSocial Worker licenseSenior Reimbursement Specialist certification