Reimbursement Specialist - Healthcare jobs in Mesa, AZ

Reimbursement Specialist - Healthcare determines the extent to which patients' insurance covers their treatments. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. Being a Reimbursement Specialist - Healthcare ensures compliance with Federal and State regulations and company policies that govern Medicare and state payment systems. May assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation. Additionally, Reimbursement Specialist - Healthcare may require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. The Reimbursement Specialist - Healthcare gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Reimbursement Specialist - Healthcare typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Reimbursement Specialist 1
  • Novartis
  • Tempe, AZ FULL_TIME
  • 394937BR

    Reimbursement Specialist 1

    USA

    About the role

    Location:

    This position will be located at the Tempe, AZ site and will not have the ability to be located remotely.

    Scheduled hours for this position will be 10am – 7pm ET (8am – 5pm and 7am – 4pm AZ time) and can be subject to change based on business needs.

    Proximity and ability to commute to work onsite in Tempe, AZ as required by our hybrid model (one week per month and for occasional meetings or events). To be scheduled at the discretion of the business.

    Roles will have a Dedicated Training Period: The individual hired for this role will be required to successfully complete initial training, including passing simulations and become certified to do the role.

    Novartis Patient Support (NPS) is projected to support over 1.4 Million patients and impact nearly $4B of Novartis’s US Pharma revenue. NPS provides mission critical support to Novartis brands by helping patients prescribed Novartis products with assistance to address any access challenges and get on medications needed to improve their health.

    The growth of an internal Patient Support Center (PSC) is a strategic priority for US Pharma. We have an incredible opportunity to formulate exciting new partnerships to deliver transformative patient ser-vices. The NPS team is uniquely positioned to help support our goal of providing appropriate medications to twice as many patients twice as fast.

    The Patient Support Center will support all franchises by providing omni-channel customer support and patient access. By leveraging workforce management, technology, and through staff retention and engagement, it will ensure strong appropriate alignment with NPS goals.

    • If you are customer-obsessed.
    • If you are energized by leading people through change.
    • If you are motivated by measured outcomes.

    You should consider joining the Novartis PSC’s Reimbursement Specialist Team.

    Job Overview:

    The Reimbursement Specialist will be responsible for providing support and information about the insurance coverage of their prescribed Novartis medicines. They will accurately and efficiently find the patient’s insurance coverage, and any other requirements by leveraging reimbursement tools and collaborating with payers and providers.

    The Reimbursement Specialist may also share appropriate information with Patient Specialty Services field teams. This information may cover coverage-related queries from customers, provide pre-authorizations for medical treatment, and outline information regarding co-payments.

    The Reimbursement Specialist must have strong communication skills to converse with payors and providers about benefits coverage and be able to offer solutions in accordance with approved procedures.

    A Reimbursement Specialist will possess an aptitude for learning and continual development.

    Your responsibilities will include, but are not limited to:
    • Develop and maintain knowledge of NPS programs and payer coverage; broaden program knowledge over time.
    • Learn and utilize protocols, information and technology to gather patient coverage information. Some of this will be completed via phone calls to payers in a prompt and courteous manner.
    • Prepare proper documentation and notifications; perform proper escalation, tracking, and follow-up
    • Evolve skills to navigate the payer landscape regarding Novartis programs over time
    • As applicable, raise innovative ideas which will drive improved efficiency and effectiveness of customer service to Team Leads

    Novartis Compensation and Benefit Summary: The pay range for this position at commencement of employment is expected to be between $40,600 and $60,800/year; however, while salary ranges are effective from 1/1/24 through 12/31/24, fluctuations in the job market may necessitate adjustments to pay ranges during this period. Further, final pay determinations will depend on various factors, including, but not limited to geographical location, experience level, knowledge, skills and abilities. The total compensation package for this position may also include other elements, including a sign-on bonus, restricted stock units, and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

    EEO Statement

    We are Equal Opportunity Employers and take pride in maintaining a diverse environment. We do not discriminate in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status. We are committed to building diverse teams, representative of the patients and communities we serve, and we strive to create an inclusive workplace that cultivates bold innovation through collaboration and empowers our people to unleash their full potential.

    Accessibility and Reasonable Accommodations: Individuals in need of a reasonable accommodation due to a medical condition or disability for any part of the application process, or to perform the essential functions of a position, please let us know the nature of your request, your contact information and the job requisition number in your message:
    • Novartis: e-mail us.reasonableaccommodations@novartis.com or call 1 (877)395-2339
    • Sandoz: e-mail reasonable.accommodations@sandoz.com or call: 1-609-422-4098

    Role Requirements

    Experience:

    Education:
    o High School Diploma required.

    Minimum Requirements:
    o 6 months of proven Reimbursement Experience (such as Healthcare, Payers or Pharmaceuticals,)
    o Experience and exposure in balancing multiple priorities with multiple audiences
    o Experience working with data entry system(s), fax machines, computer software, and telephone technology
    o Strong phone and verbal communication skills – ability to follow oral and written directions
    o Good problem-solving and critical thinking skills
    o Ability to interpret, capture and document the details of payer conversations, in a timely and efficient manner
    o Computer literacy with email, video conferencing systems and data entry systems

    Preferred Experience:
    o 1 year of Reimbursement Specialist experience within a Customer Contact Center in the Pharmaceuticals industry

    Other Work Requirements:
    o When working from home, a quiet dedicated space where the employee can work without interruption
    o Ability to work the scheduled work hours, which generally will be an 8-hour schedule with two paid rest breaks and an unpaid lunch break. Schedule hours: 10am – 7pm ET (8am – 5pm and 7am – 4pm AZ time) and can be subject to change based on business needs.

    Why Novartis: Our purpose is to reimagine medicine to improve and extend people’s lives and our vision is to become the most valued and trusted medicines company in the world. How can we achieve this? With our people. It is our associates that drive us each day to reach our ambitions. Be a part of this mission and join us! Learn more here: https://www.novartis.com/about/strategy/people-and-culture

    You’ll Receive: You can find everything you need to know about our benefits and rewards in the Novartis Life Handbook. https://www.novartis.com/careers/benefits-rewards

    Commitment to Diversity & Inclusion: Novartis is committed to building an outstanding, inclusive work environment and diverse teams representative of the patients and communities we serve.

    Join our Novartis Network: If this role is not suitable to your experience or career goals but you wish to stay connected to hear more about Novartis and our career opportunities, join the Novartis Network here: https://talentnetwork.novartis.com/network

    Division

    US

    Business Unit

    Novartis Patient Support

    Work Location

    Tempe, AZ

    Company/Legal Entity

    Novartis Pharmaceuticals

    Functional Area

    Market Access

    Job Type

    Full Time

    Employment Type

    Regular

    Shift Work

    No

    Early Talent

    Yes
  • 30 Days Ago

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Healthcare Treatment Specialist
  • Serenity Healthcare
  • Gilbert, AZ FULL_TIME
  • Healthcare Treatment Specialist Do you enjoy making a positive impact on other people’s lives? Would you like to work in an environment where you can build strong relationships with your patients whil...
  • 1 Month Ago

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Healthcare Treatment Specialist
  • Serenity Healthcare
  • Queen Creek, AZ FULL_TIME
  • Healthcare Treatment SpecialistDo you have previous customer service experience, and do you enjoy making an impact? We are seeking a Healthcare Treatment Specialist for our Queen Creek, AZ office. The...
  • 1 Month Ago

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Healthcare Release Of Information Specialist
  • TEKsystems
  • Mesa, AZ FULL_TIME
  • Entry Level Release of Information Specialist Responsible for processing all release of information requests in a timely and efficient manner ensuring accuracy and providing customers with the highest...
  • 1 Day Ago

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Healthcare Credentialing Specialist
  • Worldwide Medical Staffing
  • Gilbert, AZ FULL_TIME
  • Worldwide Medical Staffing is a Joint Commission Certified, Native-Veteran-Owned Healthcare Staffing Agency located in Gilbert, AZ. We are seeking a credentialing specialist to join our team for in-pe...
  • 7 Days Ago

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Healthcare Compliance Specialist
  • Adaptive Workforce Solutions
  • Gilbert, AZ FULL_TIME
  • Healthcare Compliance Specialist Adaptive Workforce Solutions seeks an experienced Healthcare Compliance Specialist to join the team at our headquarters in Gilbert, AZ. As the Compliance Specialist, y...
  • 30 Days Ago

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0 Reimbursement Specialist - Healthcare jobs found in Mesa, AZ area

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Fountain Hills, AZ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Sun City West, AZ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • San Tan Valley, AZ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Mesa, AZ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Goodyear, AZ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Cave Creek, AZ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • El Mirage, AZ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Surprise, AZ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

Mesa (/ˈmeɪsə/ MAY-sə) is a city in Maricopa County, in the U.S. state of Arizona. It is a suburb located about 20 miles (32 km) east of Phoenix in the East Valley section of the Phoenix Metropolitan Area. It is bordered by Tempe on the west, the Salt River Pima-Maricopa Indian Community on the north, Chandler and Gilbert on the south along with Queen Creek, and Apache Junction on the east. Mesa is the largest suburban city by population in the United States, the third-largest city in Arizona after Phoenix and Tucson, and the 36th-largest city overall in the US. The city is home to 496,401 pe...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$44,507 to $54,082
Mesa, Arizona area prices
were up 2.2% from a year ago

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