Lumicera Health Services is seeking a Reimbursement Specialist I to join our team!
Under direction from the Assoc. 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!
ResponsibilitiesHow 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
- Other duties as assigned
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 Navitus?
- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
#LI-Remote
Location : AddressRemote Location : CountryUSSkills Required
- High school diploma or equivalent GED
- Some college
- Certified Pharmacy Technician certification
- Pharmacy technician license or pharmacy technician trainee license where required by state
- Experience with pharmacy, health plan, or clinical insurance claims billing
- Experience with benefit assessments, billing and claims documentation, or claims auditing
- Ability to participate in and support compliance program objectives
- Ability to interact cooperatively and respectfully with other employees
What We Do
A leading applied technology services company, we innovate to deliver service excellence and successful outcomes across sales, delivery and development. With our strategy to be agile, nimble and customer-centric, we anticipate the future of applied technology and predict tomorrow’s trends to keep our clients at the summit in an ever-changing marketplace. Leading with architecture and design, our next-gen solutions enable enterprises to accelerate on their digital transformation journey.
