Reimbursement Specialist I
Lumicera Health Services · United States
- Hybrid
- Full-time
- $45,500 / year
- United States
Job highlights
- Process manufacturer copay assistance reimbursements.
- Ensure accurate patient billing information setup.
- Resolve claim issues and reduce outstanding balances.
- Handle patient billing inquiries and options.
- Maintain accurate reimbursement and insurance data.
About the role
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
Skills & topics
- Reimbursement Specialist
- Specialty Pharmacy
- Copay Assistance
- Claims Processing
- Billing
- Patient Accounts
- Insurance Claims
- Pharmacy Technician
- Healthcare
- Remote
How to get hired
- Tailor your resume: Highlight pharmacy billing, claims processing, and copay assistance experience.
- Emphasize preferred qualifications: Showcase any CPhT certification or pharmacy technician licensure.
- Address remote work restrictions: Ensure your location complies with Lumicera's remote work policy.
- Prepare for behavioral questions: Practice scenarios demonstrating accuracy, compliance, and teamwork.
- Showcase customer service skills: Detail experience handling patient inquiries and complaints.
Technical preparation
Behavioral questions
Frequently asked questions
- What is the hourly pay for a Reimbursement Specialist I at Lumicera Health Services?
- The pay range for a Reimbursement Specialist I at Lumicera Health Services is USD $18.67 - USD $21.96 per year. Specific compensation will depend on factors such as experience and location.
- Is this a remote position for Lumicera Health Services?
- This is a remote position, however, 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. Please verify your eligibility based on your state of residence.
- What are the primary responsibilities of a Reimbursement Specialist I at Lumicera Health Services?
- The primary responsibilities include obtaining and processing manufacturer copay assistance reimbursements, ensuring accurate patient billing setup, resolving claim issues, handling patient billing inquiries, and maintaining accurate reimbursement information.
- What qualifications are preferred for the Reimbursement Specialist I role?
- Preferred qualifications include some college education, CPhT certification, and a pharmacy technician license or trainee license. Experience with insurance claims billing, benefit assessments, or claims auditing is also preferred.
- What is the work schedule for this Reimbursement Specialist I position?
- The work schedule for the Reimbursement Specialist I position is Monday to Friday, from 10:30 AM to 7:00 PM.
- Does Lumicera Health Services offer benefits for this role?
- Yes, Lumicera Health Services offers a comprehensive benefits package including Health, Dental, and Vision insurance, 20 days of paid time off, 4 weeks of paid parental leave, 9 paid holidays, and a 401K company match.
- How does Lumicera Health Services ensure equal employment opportunities for the Reimbursement Specialist I role?
- Lumicera Health Services is committed to equal employment opportunity and complies with all applicable nondiscrimination regulations, ensuring consideration for employment without regard to race, color, religion, sex, national origin, or handicap.