Case Manager, Reimbursement at United Biosource Corporation

, , United States -

Full Time

Start Date

Immediate

Expiry Date

17 May, 26

Salary

0.0

Posted On

16 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Patient Advocacy, Inbound Phone Support, Outbound Phone Support, Eligibility Determination, Prior Authorization, Appeal Processing, Benefit Communication, Case Coordination, Troubleshooting, Adverse Drug Event Reporting, Product Quality Complaint Handling, Microsoft Office, Claims Processing Terminology, Written Communication, Verbal Communication

Industry

Biotechnology Research

Description

As a pharmaceutical support industry leader, UBC is devoted to empowering health solutions for a better tomorrow. We take pride in improving patient outcomes and advancing healthcare. At UBC we provide services to enhance the entire drug development process and commercialization lifecycle - From clinical trial support to real-world evidence generation. Embark on a rewarding career journey with UBC! Grow your career while making a meaningful impact on the world around you. UBC fosters a culture built on our Core Values being: Collaborative, Conscientious, Curious, Consultative, and Compassionate. We believe in an inclusive workplace that fosters creativity. If you are seeking a career that will challenge, inspire, and reward you, join us at UBC! At UBC, the Reimbursement Case Manager serves as a patient advocate, removing barriers for patients accessing specialty pharmaceuticals. As the single point of contact you will provide inbound and outbound phone support to patients, caregivers, and providers to collaboratively determine patient eligibility. In addition to prioritizing and enhancing the patient experience, the reimbursement case manager will coordinate the patient's access to therapies, conduct the appropriate follow ups, and facilitate access to support services such as co-pay assistance programs and patient assistance programs (PAP). Specific job duties: * Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required. * Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders. * Communicate patient benefits and responsibility timely and accurately. * Assess and refer patients appropriately for special programs/services when appropriate. * Performs quality checks on cases and report trends to leadership. * Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures. * Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy * Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements. * Recognize a product quality complaint and forward caller/written information to a manufacturer. * Other duties, as assigned. Desired Skills and Qualifications: * Bachelor’s degree or six years of relevant working experience * Two (2) or more years of relevant experience in pharmacy benefit management preferred * 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 * Travel required on an as needed basis * Must be able to work shifts that end up until 9PM EST. Benefits: At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally. Here are some of the exciting perks UBC offers: * 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 UBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class. We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients.

Responsibilities

The Case Manager acts as a patient advocate, serving as the single point of contact to provide phone support to patients, caregivers, and providers to determine eligibility and coordinate access to specialty pharmaceuticals and support services. Key duties include managing caseload oversight, handling prior authorization and appeal processing communications, accurately communicating benefits, and troubleshooting complex cases.