Reimbursement Specialist

About Lumicera Health Services

Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions. Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.

Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.

We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $18.67 - USD $21.96 / Yr.

STAR Bonus % (At Risk Maximum)

0.00 - Ineligible

Work Schedule

M-F 10:30AM-7PM

Remote Work Notification

ATTENTION: Lumicera is unable to offer remote work to residents of Alaska, Connecticut, Delaware, Hawaii, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.

Overview

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.

Responsibilities

How do I make an impact on my team?

• 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.

Qualifications

What our team expects from you?

• High School Diploma or equivalent GED. Some college preferred.
• CPhT preferred.
• Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure.
• Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

What can you expect from Navitus?

• Top of the industry benefits for Health, Dental, and Vision insurance.
• 20 days paid time off.
• 4 weeks paid parental leave.
• 9 paid holidays.
• 401K company match of up to 5% - No vesting requirement.
• Adoption Assistance Program.
• Flexible Spending Account.
• Educational Assistance Plan and Professional Membership assistance.
• Referral Bonus Program – up to $750!

Key skills/competency

• Reimbursement Specialist
• Specialty Pharmacy
• Copay Assistance
• Claims Processing
• Billing Procedures
• Patient Accounts
• Insurance Claims
• Pharmacy Software
• Compliance
• Customer Service