Experienced Reimbursement Specialist/Medical Biller (Remote)

Experienced Reimbursement Specialist/Medical Biller (Remote)

Remote Role – Location (Open to Remote US)

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma get their medicines to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product’s value to payers, physicians and patients. A significant part of our business is acting as the biopharma’s sales force to physicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.

Position Summary:

AllCare Plus Pharmacy, an IQVIA company, is seeking a Reimbursement Specialist! Responsible for the daily evaluation and collaboration of identifying and addressing departmental needs and priorities. Is responsible for proper completion of all daily tasks in a timely fashion while ensuring compliance with all standard operating procedures, cross functionally. This is a remote position.

Hours: Ability to work 40 hours per week.

Shifts based on availability: 8:30 am EST – 5:00 pm EST or 9:00 am - 6:00 pm EST or 10:00 am - 7:00 pm EST or 11:00 am EST – 8:00pm EST under moderate supervision

Salary: $23/hr

The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. AllCare Plus Pharmacy reserves the right to revise the job or to require that other or different tasks be performed as assigned.

Primary Responsibilities:

Work closely with the Program Sr. Director, Program Director, and the Program Managers to evaluate departmental needs and priorities Schedule and delegate projects amongst team members, as needed, to address departmental priorities Assist with projects or assignments as directed by Directors to support departmental priorities Track, assist in research, trend, and communicate issues identified among staff during projects Work collaboratively with cross functional teams to ensure all updates made by the Reimbursement Coordinator(s) and/or CM(s) that may impact other functional areas are communicated to all impacted persons/teams in a timely manner Work with call center leadership to identify improvements and provide plan of action proposals Consistently meet excellent quality requirements and follow all required interaction components as outlined in departmental SOP’s and protocols Maintain strong working knowledge of insurance carriers and third-party billing requirements Assist with the creation and review of SOPs Identify and quantify payor issues and proposed solutions

Required Qualifications:

• Associate’s Degree preferred
• Minimum 3 years’ experience in pharmacy, healthcare, medical billing, insurance verification or similar experience
• Minimum of 1 year working cross functionally among billing & reimbursement and/or HUB services departments
• Exceptional communication and facilitation skills, both verbal and written, with a proven ability to communicate to all levels of the organization
• Data entry skills and ability to type 30wpm+

Preferred Qualifications:

Experience verifying insurance eligibility and coverage including but not limited to: benefits, pre-certification and referrals, reimbursement Previous supervisory and training experience

Professional Competencies:

Business Skills and Knowledge

• General Management

Demonstrate analytic and problem solving skills, and understand the impact of individual decisions on other parts of the organization and the environment.

• Risk management

Knowledge of liability and compliance regulation, the ability to employ strategies to mitigate risk, avoid malpractice and plan for disasters.

• Quality improvement

Application of techniques that continually improve the quality of care provided, patient safety, organizational performance, and the financial health of the organization.

Knowledge of the Health Care Environment

• Health Care Systems and Organizations

Demonstrate an understanding of how the various components of the health care system is organized and financed, and how they interact to deliver medical and health care.

• The Patient’s Perspective