Case Manager, Reimbursement

Reimbursement Case Manager responsible for serving as a patient advocate and coordinating access to specialty pharmaceuticals. Primary duties include providing inbound and outbound phone support to patients, caregivers, and providers to determine patient eligibility; acting as the single point of contact for prior authorization and appeal processing communications with patients, healthcare providers, field reimbursement representatives, and other external stakeholders; communicating patient benefits and responsibilities; assessing and referring patients to appropriate programs/services; performing quality checks and reporting trends to leadership; troubleshooting complex cases across multiple disease states; and reporting adverse drug events. The role requires strong knowledge of medical terminology and claims processing, excellent written and verbal communication, and the ability to manage caseloads while adhering to safety and environmental programs. Remote opportunities are available, with a focus on supporting patient access throughout the reimbursement process.