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Reimbursement Specialist I-Remote - Phoenix, AZ, US | Remote, US | Madison, WI, US

Lumicera Health Services Powered by Navitus

Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship.  Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. 

We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Under direction from the Associate Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, the Reimbursement Specialist I is primarily responsible for following standard operating procedures to obtain and process manufacturer copay assistance program reimbursement. The Reimbursement Specialist I shall have knowledge of billing procedures and work to reduce discrepancies, inaccuracy, and outstanding balances. The Reimbursement Specialist I may also assist in contacting patients with an outstanding balance to communicate billing options. 

Is this you? Find out more below! 

How do I make an impact on my team?  

  • Responsible for ongoing monitoring of claims activity for accuracy and successful submission.
  • Responsible for ensuring that patient billing information is set up appropriately in the pharmacy software. 
  • Participate, as necessary, in conferences and meetings related to reimbursement/billing.
  • Responds to employee/patient/client questions or complaints regarding reimbursement and/or billing.
  • Works with internal teams to review and resolve claim issues.
  • Maintains accurate reference information relating to reimbursement and copay assistance.
  • Responsible for accurate and thorough documentation of information, insurance and prescriptions/orders within the patient profile.
  • The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve.  Thus, legal and ethical compliance is an essential duty of each employee.

What our team expects from you? 

  • High School Diploma or equivalent GED.   Some college preferred
  • CPhT preferred
  • Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure. 
  • Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred.
  • Participate in, adhere to, and support compliance program objectives
  • The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Lumicera?

  • Hours/Location: Monday-Friday 8:00am-5:00pm CST, Madison WI Location, Phoenix AZ Location or Remote
  • Paid Volunteer Hours
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!
  • Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Eight paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program
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Job Profile

Regions

North America

Countries

United States

Benefits/Perks

401(k) Adoption Assistance Adoption Assistance Program College Savings Plan Educational Assistance Educational Assistance Plan Eight paid holidays Employee Assistance Program Flexible Spending Account Health, Dental and Vision Insurance Paid parental leave Paid Time Off Paid Volunteer Hours Professional Membership assistance Referral Bonus Referral Bonus Program Short Term and Long Term Disability

Skills

Benefit assessments Billing procedures Claims Auditing Claims billing Compliance Documentation Pharmacy Pharmacy software

Tasks
  • Ensure legal and ethical compliance
  • Maintain accurate documentation
  • Monitor claims activity
  • Participate in conferences and meetings
  • Respond to questions/complaints
  • Review and resolve claim issues
  • Set up patient billing information
Experience

0 years

Education

Associate CPhT GED High school diploma Pharmacy Some college

Certifications

CPhT CPhT (Certified Pharmacy Technician)

Restrictions

Not available for residents of specified states Residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9