Payor Reimbursement Specialist

Onco360 has an immediate need for a Payor Reimbursement Specialist .

This position will work Remote.

Full Time, Monday to Friday from 9:00am to 5:30pm.

• 401k with a match
• Paid Time Off and Paid Holidays
• Tuition Reimbursement
• Company paid benefits - life insurance, short and long-term disability
• Participates in new Payer launch activities ensuring collaboration between Reimbursement, Payer Sales, and Operations teams.
• Manage all updates, reviews, and contract document maintenance including Payor Contracting faxes, PBM Fax Blasts and emails received via all locations’ Contracting addresses.
• Communicate to Pharmacy personnel payor benefit programs and policies as needed or directed by Reimbursement leadership.
• Communicate new medication access to all managed clients, as well as managing medication access inquiries.
• Analyze and report on company “No Go’s” to evaluate contracting opportunities.
• Manage all Operations payor escalations (AskOps).
• Initiating and executing letter of agreements (LOAs) for out of network providers based on patient need as well as manage active and expiring LOAs.
• Assist with credentialing, Medicaid enrollment, and licensing needs as required by payer or internal reimbursement team.
• Maintain a positive, professional attitude when dealing with Onco360/CareMed employees and clients.
• Perform other tasks as assigned.
• Required: Previous Experience in Pharmacy or Medical Billing, AR or Credential/Contracting
• Desired: Bachelor’s degree in Business, Life Sciences, or other related field.
• Required: 3+ in Healthcare/ Medical provider practice
• Desired: 5+ in Specialty Pharmacy
• Required: Must have excellent interpersonal skills and be able to work with all levels of management and staff, both technical and non-technical. Strong, independent decision-making abilities are required. Must be able to conduct research, be resourceful, and self-reliant. Excellent communication skills including negotiation skills; must be persistent and persuasive.
• Required: Strong work ethic with excellent time management skills, excels at working independently but collaborative in a group setting as well. Detail oriented, proficient at prioritization of workload.