Reimbursement Case Manager. Will serve as an expert on reimbursement issues and be responsible for handling the day-to-day activities within reimbursement services (benefits investigation, prior authorizations and appeals support). Complete medical and/or pharmacy benefit investigations, identify and facilitate submission of required documentation for payer/plan review for prior authorization, step edit identification and appeals according to pro...
Purpose. . . The Reimbursement Case Manager is a professional client facing role responsible for various functions, functions related to supporting patients, healthcare providers, and business partners with circumstances related to pharmacy reimbursements, including accurate and timely response to client inquiries regarding specific referral status or escalation. The Reimbursement Case Manager serves as a primary point of contact for professiona...
