Call Center Reimbursement Counselor

The seasoned experts of bring in-depth, practical knowledge of Medicare and private-payer coding, billing and coverage policies. Our reimbursement support programs connect patients with funding sources that give them access to life-saving treatments. Our experienced consultants monitor industry and regulatory trends, research reimbursement scenarios and help manufacturers eliminate new-product barriers.

 

·        Work under general supervision in a fast paced, high-volume contact center environment.

·        Provides reimbursement support to customers relative to contracted services of the assigned pharmaceutical manufacturer reimbursement, patient assistance and appeals programs. (Customers include prescribers, patients, pharmaceutical clients and pharmacies)

·        Counselors must maintain current knowledge of reimbursement programs/policies specific to manufacturer products within the assigned program and program guidelines for all assigned client service offerings.

·        Counselors must have an in depth understanding of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits.

·        Counselors must also have an in-depth understanding of Medicare, Medicaid and various public funding programs in order to effectively support the pharmaceutical clients. 

 

Minimum Requirements:

 

·        Minimum of one (1) year experience in a call center environment, healthcare and/or insurance setting. 

·        Certification in medical billing and coding, pharmacy technician or healthcare advocacy preferred.

·        ICD-9 and CPT experience preferred.

·        Working knowledge of MS Office Products (Outlook, Word and Excel) required.

·        Siebel database experience preferred. 

 

Education:

 

High School diploma or equivalency is required.