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UBC - Reimbursement Specialist
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Job ID: REQ20004225
The primary goal of this position is to provide high
quality customer service and effectively interface with patients, patient s
families, national payers, home cares and medical doctor s offices to assist
patient and medical provider in expediting the process starting the patient on
client product and ensure the highest level of reimbursement is attained for
* Conduct benefit investigations, verify
insurance benefits for patient and physicians office, and submit and obtain
prior authorization as required by payer; obtain recertification for cases
requiring extended treatment/coverage beyond the expiration of original
* Accurately enter and maintain data as
required in client database and patient files and utilize the client database
to monitor outstanding items on each client case file. Ensure files are
complete so team can determine the current status.
* Participate in conference calls with Client
Sales Representatives, client management and physicians offices regarding
status of cases, drug orders and status of alternative funding
* Provide coordination of order for product,
shipment of product, and therapy initiation with pharmacy and patient.
* Participate in Call Center Activities, triage
and respond to incoming calls from patients, insurance companies, physicians,
Sales Reps, pharmacies and homecare agencies. May serve as single point of
contact for an assigned group of prescribers.
* Identify and report events as required by the
REMS requirements for specified medication. Recognize adverse event, product
quality complaint and potential risk events and forward information to the
appropriate team member for reporting to the manufacturer.
* Educate patients, prescribers, and others
regarding program requirements, and facilitate referrals. Maintain good
housekeeping techniques, adhering to quality and production standards and
comply with all applicable company, state, and federal safety and environmental
programs and procedures.
* High School Diploma or GED required.
Bachelor s Degree preferred.
* 4 -6 years experience in the insurance,
biotechnology, or pharmaceutical industries; customer service and/or
reimbursement. Health Insurance claims or patient accounting experience a plus.
* Computer proficiency in MS Office
applications, with database experience a plus.
* Excellent written and verbal communication
skills, with demonstrated ability to communicate with others at all levels.
Ability to manage multiple priorities and meet deadlines. Detail oriented with
good analytical skills. Knowledge of third party billing, coding, medical
terminology, prior authorizations and appeals preferred.
ABOUT EXPRESS SCRIPTS
Advance your career with the company that makes it easier for people to choose better health.
Express Scripts is a leading healthcare company serving tens of millions of consumers. We are looking for individuals who are passionate, creative and committed to creating systems and service solutions that promote better health outcomes.
Join the company that Fortune magazine ranked as one of the 'Most Admired Companies' in the pharmacy category. Then, use your intelligence, creativity, integrity and hard work to help us enhance our products and services.
We offer a highly competitive base salary and a comprehensive benefits program, including medical, prescription drug, dental, vision, 401(k) with company match, life insurance, paid time off, tuition assistance and an employee stock purchase plan.
Express Scripts is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation.
Express Scripts is a VEVRAA Federal Contractor.
United BioSource Corporation (UBC) is the leading provider of integrated development and commercial support solutions that deliver evidence of safe use, while optimizing access to mediation and care.
UBC leverages our specialty pharmacy therapy expertise and contracts for specialty pharmacy and specialty distribution services.
UBC's services include reimbursement, patient assistance and alternate funding programs, channel optimization through specialty pharmacy, specialty distribution and 3PL services, Customized clinical adherence and commercialization strategies powered by Express Scripts data.
Express Scripts is an EOE
Express Scripts is an Equal Employment Opportunity employer and does not discriminate in employment opportunities or practices on the basis of race, creed, color, religion, sex, national origin, nationality, ancestry, age, disability or status as a disabled veteran or veteran of the Vietnam era, pregnancy, affectional or sexual orientation, gender identity or expression, marital status, status with regard to public assistance, veteran status, citizenship or membership in any other legally protected class. None of the questions in this application are intended to elicit information regarding any protected characteristics, nor imply any limitation, illegal preferences or discrimination based upon non-job-related information or protected characteristics.Applicants must be able to pass a drug test and background investigation and, depending on position requirements, a Department of Defense background investigation. AA/EOE.