Reimbursement Specialist

This is an exciting opportunity for an experienced drug reimbursement professional with strong leadership capabilities to join a growing healthcare organization in a key operational role.

The Reimbursement Specialist will take on a lead role, by overseeing the day-to-day activities of a reimbursement team, ensuring work is effectively coordinated, service levels are maintained, and complex cases and escalations are handled appropriately. You will act as a knowledgeable resource for the team while also working closely with healthcare provider offices and other external partners.

The successful candidate will be someone who understands the complexities of public and private drug coverage, can confidently troubleshoot challenging reimbursement situations, and enjoys coaching others and improving the way work gets done.

This is a hands-on lead position that is perfect for someone who wants to remain close to the day-to-day operation rather than move into a purely administrative management role.

Your responsibilities will include but are not limited to…

• Coordinate daily workflow and provide hands-on leadership, coaching, and mentorship to the reimbursement team.
• Serve as a senior resource for complex reimbursement files, escalations, and procedural questions, providing support during high-volume periods.
• Build and maintain strong relationships with healthcare providers and external partners to ensure effective service delivery and address issues proactively.
• Review files, workflows, and performance metrics to identify gaps, improve quality, and enhance team productivity and efficiency.
• Develop and maintain procedures and workflows while supporting the implementation of new programs and operational initiatives.
• Act as a subject matter expert on public and private drug reimbursement processes, ensuring compliance with applicable policies and regulations while handling confidential information with discretion.