Bilingual KYC servicing representative reviewing documentation, managing cases, and handling Card Member interactions. Supporting American Express compliance operations and risk mitigation.
About the role
- Bilingual Reimbursement Specialist guiding Canadian diabetes patients through insurance and prior authorization for Insulet’s Omnipod system. Processing claims and coordinating with payers, providers, and commercial teams.
Responsibilities
- Understand Insulet insurance contracts, channeling, and processing requirements for covered products
- Process reimbursement by contacting payors, verifying insurance benefits, and adhering to medical guidelines
- Submit prior authorization requests for approval and payment of Insulet products during claim processing
- Calculate and document cost-share amounts for English- and French-speaking customers
- Collaborate with Case Management, Omnipod Sales, Billing, and other commercial teams on customer order status
- Document interactions and calls in the customer database
- Maintain compliance with HIPAA and other regulatory bodies
- Provide feedback and suggestions for continuous process improvement
- Perform other duties as required
- Guide patients and customers through insurance, reimbursement, and prior authorization processes
- Serve as a resource for patients, healthcare providers, insurance payers, and internal teams
Requirements
- Associate's Degree
- Proficiency in both English and French strongly preferred
- Bachelor's Degree preferred
- 2-4 years in a medical device, pharmaceutical, healthcare, or consumer product related field preferred
- Knowledge and understanding of the managed care industry preferred
- Knowledge of and experience supporting patients with diabetes preferred
- Experience in reimbursement or working with private or public payers in Canada
- Experience with Salesforce or another CRM system preferred
- Ability to work overtime to meet business objectives required
- Effective oral and written communication in English and French
- Problem-solving, collaboration, accountability, self-management, prioritization, and multitasking skills
- Proficiency with MS Office applications and CRM systems
- Ability to work in a normal office environment, including sitting and standing
- Manual dexterity for using a computer keyboard
- Lightweight lifting may be required
Benefits
- 100% remote working arrangements; may work from home/virtually 100%
- Hybrid on-site/virtual work may be chosen as desired
- Reasonable accommodations for individuals with disabilities
- Opportunity to leverage bilingual language skills while building expertise in reimbursement, managed care, and medical devices
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