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Senior Case Manager, Reimbursement

Posted today

virtual vocationsDenver (CO)

SENIORITY

Senior

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About the role

To support a growing pharmaceutical support practice, the full-time Senior Case Manager, Reimbursement will manage a caseload, ensuring timely completion of prior authorizations, reauthorizations, and appeals while acting as a primary resource for patients and healthcare providers in a remote setting.
Key responsibilities: Provide oversight and coordination of caseload to ensure timely completion of case elements and tasks Act as the single point of contact for prior authorization and appeal processing communications with patients and external stakeholders Serve as a patient advocate, coordinating access services and troubleshooting complex cases across multiple disease states
Required qualifications: Bachelor's degree or six years of relevant working experience Five or more years of experience in pharmacy benefit management, specialty pharmacy, or patient support/access services preferred Three or more years of experience in pharmacy and/or medical benefit verifications, prior authorization, and/or appeals required Experience as a Medical Assistant, Social Worker, or Senior Reimbursement Specialist preferred Proficiency in Microsoft Office applications and knowledge of medical and claims processing terminology

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