Senior Bilingual Reimbursement Specialist – Rare Diseases

• Act as the Team Lead and primary resource for all Reimbursement Specialists within the rare diseases program
• Maintain in-depth knowledge of rare disease program offerings, pathophysiology, therapeutic areas, disease processes, mechanisms of action, and rare disease SOPs
• Communicate daily and continuously with the Program Manager or Associate Program Manager regarding new and existing projects
• Evaluate, develop, maintain, and implement reimbursement processes and protocols
• Implement, monitor, and evaluate departmental KPIs
• Coordinate cases with insurance companies, physician offices, and healthcare professionals to maximize reimbursement solutions
• Prepare and submit documentation and data to insurance companies and public or federal funding programs
• Navigate complex advocacy processes to obtain prescription drug coverage and reimbursement
• Apply financial means testing to maximize patients’ prescription drug coverage
• Coordinate pharmacy processes after funding is obtained
• Manage closing manager schedules and shifts
• Provide sales training related to product reimbursement
• Report adverse events to the relevant departments
• Perform other duties and tasks as assigned

Requirements

• At least three years of experience in the pharmaceutical, biotechnology, or healthcare industry
• Bachelor’s degree and/or a combination of education and experience in a related industry
• Four years of experience in public or private third-party reimbursement, pharmaceutical sales, hospital or physician office settings, managed care, clinical support, or a related field
• Minimum of three years of experience as a Senior Reimbursement Specialist
• Experience in rare diseases may be required
• Knowledge of public, private, and federal reimbursement mechanisms
• Advanced knowledge of the pharmaceutical or insurance industry
• Strong business and financial acumen
• Strong analytical and mathematical skills
• Ability to lead a team and provide direction
• Strong communication and interpersonal skills, including the ability to communicate with patients in a healthcare setting about sensitive topics
• Professional, courteous, and efficient telephone manner
• Strong proficiency in Microsoft Outlook, Word, Excel, PowerPoint, and other Microsoft Office programs
• Proven ability to organize time, set priorities, and multitask
• Ability to work independently and in a team environment
• Strong attention to detail
• Ability to consistently meet deadlines
• Excellent problem-solving skills
• French/English bilingualism is an asset
• Experience in IT project management, customer service, reimbursement programs, or the insurance industry is an asset

Core Competencies

Demonstrates expertise in reimbursement processes and protocols within the pharmaceutical and healthcare industries, with a strong focus on rare diseases. Capable of leading teams, managing projects, and effectively communicating with various stakeholders to optimize patient access to prescription drug coverage.

Highest-signal resume keywords

• Reimbursement Processes
• Rare Disease Knowledge
• Team Leadership
• Analytical Skills
• Communication Skills

Hard Skills

• Reimbursement Mechanisms
• Financial Means Testing
• Pharmaceutical Sales
• Public Funding Programs
• KPI Monitoring
• Data Submission
• Analytical Skills
• Mathematical Skills
• Project Management
• Customer Service

Soft Skills

• Interpersonal Skills
• Problem-Solving Skills
• Attention to Detail
• Time Management
• Multitasking

Industry Keywords

• Pharmaceutical Industry
• Biotechnology
• Healthcare
• Managed Care
• Clinical Support
• Insurance Industry
• Rare Diseases
• Third-Party Reimbursement
• Advocacy Processes
• Bilingualism

Tools & Technologies

• Microsoft Outlook
• Microsoft Word
• Microsoft Excel
• Microsoft PowerPoint
• Microsoft Office