Reimbursement Specialist

#LI-DNI JOB DESCRIPTION POSITION Reimbursement Specialist COMPANY AND LOCATION Specialty Pharma Solutions (Oshawa) EMPLOYMENT TYPE Permanent, Full-time HOURS WORKED Monday to Friday, 9 am to 5 pm DEPARTMENT Pharmacy REPORTING TO Designated Manager, Pharmacy DIRECT REPORTS? None POSITION SUMMARY: The Reimbursement Specialist is responsible for assisting in the navigation of public and private insurance providers to determine coverage options for medication therapy.

Additional responsibilities include providing support for all dispensing related activities in the pharmacy including but not limited to, answering phone calls, processing prescriptions, scheduling deliveries, labelling, and collecting payments.

This specialty pharmacy is closed to the public; medications are sent directly to patients or medical clinics.

We are looking for a candidate who is reliable, organized, and works with a sense of urgency.

The successful candidate should also possess excellent communication skills and a passion for delivering superior customer service.

Preference will be given to candidates who are proficient with Kroll PMS and have experience troubleshooting adjudication issues with public and private insurers.

GENERAL RESPONSIBILITIES & ESSENTIAL FUNCTIONS: Maintaining patient files, including accurate entry of patient care information including allergies and medical conditions Accurate data entry of prescriptions into Kroll and filling/billing such prescriptions Communicate with patients, prescribers, healthcare professionals and other key stakeholders to support patients throughout their treatment journey Maintain confidentiality of patient healthcare information at all times Investigate and support the reimbursement process for insurance coverage and benefits for patients, including eligibility, co-payments, deductibles, and special/prior authorizations Liaise with public/private insurers and patient assistance programs to determine coverage options for patients Scheduling of medication deliveries with patients Maintaining prescription and OTC drug inventory, including completing inventory counts, checking expiry dates and placing drug orders Maintain a clean and organized dispensary QUALIFICATIONS Experience with Kroll Pharmacy Management Software (preferred) Excellent Knowledge of MS Word, Excel and G Suite Excellent customer service skills High level of professionalism Strong written, verbal, and computer skills are required Self-motivated with strong work ethic Deadline-oriented and strong prioritization skills a must Experience with patient support programs and/or special authorization process (asset) EDUCATION Highschool diploma or equivalent Completion of post-secondary education an asset WORKING CONDITIONS: Office setting Fast-paced, busy work environment Manual dexterity to complete computer work DISCLAIMER The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee.

Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

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