Reimbursement Specialist

Summary of Position:

The Reimbursement Specialist (RS) directly assists patients on identified pharmaceutical

company brands to secure private or public insurance reimbursement. They provide direct

telephone phone assistance to patients requiring reimbursement support on identified

pharmaceutical company brands. They represent the patient with private or public insurers to

optimize drug coverage and liaise with Nurses and Program Supports/Administrative

Assistants/Intake Specialists of the program to ensure optimal patient support and

communication.

Accountabilities: • Liaise with Nurses, and Program Supports/Administrative Assistants to ensure optimal patient support and communication. • Track and document all case information using the program IT system. • Identify possible Adverse events within data files. • Prepare an Adverse Event Report corresponding to every identified Adverse Event. • Review quality of report with great attention to detail and submit the AE reports to local Patient Safety department.

• Reconcile case number provided by Patient Safety Department. • Ensure quality assurance with respect to all mandates related to the patient support program. • Through patient-oriented solutions, manage challenging patient situations with empathy and patience. • Provide direct telephone assistance to patients requiring reimbursement support on identified company brands. • Assist with the completion of paperwork and follow up on the submissions pertaining to drug reimbursement/coverage through private or public insurers to optimize drug coverage. • Fulfill other duties as required.

Competencies:

• Understanding of private and public payer systems.

• Ability to work in cross-functional team.

• Proficiency in computer applications, including Microsoft Word and Excel.

• Build and maintain strong relationships with a variety of customers (patients, HCPs,

caregivers).

• Skilled in responding diplomatically and professionally to both internal and external

clients.

• Skilled in handling escalated concerns from patients and healthcare providers, with

professionalism and empathy.

• Ability to manage deadlines.

• Strong communication skills, both oral and written.

Qualifications Junior:

• Advanced English.

• College or University degree.

• Minimum 2 years of experience in drug reimbursement assistance navigation.

• Minimum 1 year of experience in a call center or Patient Support Program.

Qualifications Intermediate:

• Advanced English.

• College or University degree.

• Minimum 3 years of experience in drug reimbursement assistance navigation.

• Minimum 2 year of experience in a call center or Patient Support Program.

Qualifications Senior:

• Advanced English.

• College or University degree.

• Minimum 3+ years of experience in drug reimbursement assistance navigation.

• Minimum 2-3 year of experience in a call center or Patient Support Program.

Working Conditions and / or Job Requirements:

• Must possess ability to use standard office equipment, including a computer (finite

movements such as typing and other office functions)

• Requires mental stamina to maintain attention to detail despite interruptions, and

vision to read printed materials and a computer screen

Direct Reports:

• None