Guide new patients through the sales and healthcare reimbursement process.
Investigate insurance benefits, review clinical records, and secure prior authorizations.
Partner with field sales representatives and maintain CRM documentation.
Cala creates non-invasive prescription therapies for chronic diseases, starting with hand tremor treatment. They are a mission-driven company with products used by thousands, focusing on neurology and cardiology, and offer stock options and benefits.
Own complex and sensitive member cases end to end, including appeals, denied claims, and coverage issues, resolving them via phone and writing.
Investigate before responding, pull history, and provide answers rather than status updates, keeping members informed on their timeline.
Balance complex escalations with general support volume, driving cases through Jira, Compliance, and clinics until closed.
Maven Clinic is the world's largest virtual clinic for women and families, partnering with over 2,300 employers and health plans to provide end-to-end women's and family health programs. The company has raised over $425 million, been named to the TIME100 Most Influential Companies, and earned over 30 workplace awards, fostering a collaborative and inclusive culture.
Provide on-site and on-demand education on reimbursement challenges and support services for physician offices.
Educate on benefit investigation, prior authorization, Medicare and Commercial coverage, and patient communication streams.
Collaborate with internal hub support and case managers to ensure customer needs are met and track activities in CRM.
McKesson is a Fortune 10 healthcare company that delivers insights, products, and services to make quality care more accessible and affordable. It fosters a culture where employees can grow, make an impact, and thrive as they shape the future of health.
Manage and coach a regional team of Field Reimbursement Managers to deliver compliant access and reimbursement services.
Collaborate with Patient Services, Managed Health Care, Sales, and Access & Reimbursement Hub to ensure consistent program execution.
Monitor healthcare policy changes and drive professional development for direct reports.
AbbVie is a global biopharmaceutical company focused on discovering and delivering innovative medicines in immunology, oncology, and neuroscience. They employ over 50,000 people and are committed to making a remarkable impact on patients' lives.
Oversees internal Patient Services team including Case Managers and Reimbursement Specialists to ensure compliant patient experience.
Drives team business objectives, policy development, and cross-collaborative relationships with commercial teams.
Ensures program operations align with laws, regulations, and HIPAA guidelines while supporting patient access and support services.
Kyowa Kirin is a fast-growing global specialty pharmaceutical company that applies state-of-the-art biotechnologies to discover and deliver novel medicines in bone and mineral, intractable hematologic, hematology oncology, and rare diseases. The company is headquartered in Princeton, NJ with offices in California, Massachusetts, and Ontario, and is committed to making people smile by delivering breakthroughs.