Sr. Reimbursement Specialist

📋 Description

• Conduct benefit investigations and verify insurance coverage for patients and physicians’ offices.
• Submit prior authorization requests to payers and obtain required approvals.
• Manage recertification activities for cases requiring treatment or coverage beyond the original
• Maintain accurate patient and case information in the designated client database and patient files.
• Monitor outstanding requirements and update case records so the team has clear visibility into
• Ensure patient files are complete, accurate, and maintained according to established processes and

🎯 Requirements

• High School Diploma, GED, or equivalent professional experience.
• 4–6 years of experience in the insurance, biotechnology, pharmaceutical, customer service, or
• Experience with health insurance claims or patient accounting is a plus.
• Knowledge of reimbursement processes, third-party billing, and prior authorization procedures is
• Familiarity with medical terminology and healthcare-related processes is preferred.
• Knowledge of coding, appeals, and payer requirements is advantageous.

🎁 Benefits

• Remote work opportunities.
• Competitive salary.
• Opportunities for career growth and promotion.
• 401(k) with company match.
• Tuition reimbursement.
• Flexible work environment.