Reimbursement Specialist I

Lumicera Health Services is seeking a Reimbursement Specialist I to join our team! Under direction from the Assoc. Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, the Reimbursement Specialist I is primarily responsible for following standard operating procedures to obtain and process manufacturer copay assistance program reimbursement. The Reimbursement Specialist I shall have knowledge of billing procedures and work to reduce discrepancies, inaccuracy, and outstanding balances. The Reimbursement Specialist I may also assist in contacting patients with an outstanding balance to communicate billing options. Responsible for ongoing monitoring of claims activity for accuracy and successful submission. Responsible for ensuring that patient billing information is set up appropriately in the pharmacy software. Participate, as necessary, in conferences and meetings related to reimbursement/billing. Responds to employee/patient/client questions or complaints regarding reimbursement and/or billing. Works with internal teams to review and resolve claim issues. Maintains accurate reference information relating to reimbursement and copay assistance. Responsible for accurate and thorough documentation of information, insurance and prescriptions/orders within the patient profile. The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee. Other duties as assigned