Part-time remote RN supporting patient reimbursement, coverage, and copay administration for Cencora’s healthcare services. Managing patient files, access issues, adverse events, and case progression.
Responsibilities
Follow up with patients according to the approved/allowed cadence to obtain reimbursement-related updates and information required to support case progression
Update and maintain patient files accurately and in a timely manner
Collect, review, and record information related to coverage, claims status, and patient access matters
Escalate reimbursement issues, coverage barriers, and case-specific concerns to appropriate team members
Report adverse events identified during patient interactions according to company policies and procedures
Maintain accurate and current records in applicable systems and department files
Compile reimbursement-related information for reporting, tracking, and case management
Interact with internal team members and management to resolve case-related and workload-related issues
Maintain positive and professional working relationships with associates, management, and internal stakeholders
Comply with applicable policies, procedures, privacy requirements, safety rules, and program guidelines
Perform related reimbursement support duties as assigned
Requirements
Post-secondary education in a related field
1-3 years’ experience in an administrative role in a pharmaceutical setting
In-depth knowledge of Microsoft Office Suite applications
Proven accuracy when processing large amounts of data
Strong communication and interpersonal skills
Ability to work independently and in a team environment
Adaptability to change and willingness to learn new skills
High School Diploma/GED or equivalent experience required
2+ years of experience in patient access, reimbursement, prior authorization, benefit verification, managed care coordination, specialty pharmacy, or a related field required
Registered Nurse (RN) license or equivalent certification required
Prior Authorization Certified Specialist (PACS), or equivalent certification preferred
Knowledge of patient support program operations and case-based service delivery models
Knowledge of call center operations, service workflows, and quality assurance practices
Knowledge of training coordination, coaching support, and learning administration practices
Knowledge of reimbursement support, adherence, education, and patient support programs
Knowledge of operational reporting, work allocation, and scheduling support practices
Ability to coordinate assigned projects and operational activities within established program structures
Ability to support training development and delivery across patient support activities
Ability to provide first-line guidance on routine process and workflow inquiries
Ability to monitor service quality activities and identify issues requiring follow-up
Ability to organize work, manage priorities, and support multiple operational activities
Ability to communicate effectively in writing and verbally with internal stakeholders
Ability to work within defined service hours and support operational continuity requirements
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