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Reimbursement Specialist - (Contractor)

California


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The Position

This position is currently a "Locally Remote" position.  At this time we are having people work from home that are in the Greater San Francisco area, with the potential to return in-office in 2022.

The Reimbursement Specialist investigates patients' insurance benefits and obtains prior authorization information for Genentech products at the patient/family request.

Contract duration: 4 to 6 months possible extensions based on performance.

  • Investigates patients insurance benefits, mostly on the phone (90%)

  • Identifies network providers, provider restrictions, co-pays as needed (90%)

  • Documents requirements for prior authorization and medical review process (90%)

  • Documents activities appropriately in progress notes (90%)

  • Pursue product coverage for patients in accordance with the payers authorization requirements within the departments established performance criteria

  • Maintains payer profiles by recording payer specific data promptly into the system

  • Convey outcomes of benefit investigation to internal contacts (i.e. case managers)

  • Ability to learn processes for multiple products and effectively apply learnings to provide effective reimbursement services

  • Conducts all work in a compliant manner. Quality Reviews will be conducted monthly to ensure compliance standards are met.

  • Consults with team members on an as needed basis

  • This position requires some flexibility in work shift. Business Hours are 5AM-5PM Pacific Standard Time. 

  • Periodic mandatory additional hours is required

The successful candidate will demonstrate the following competencies critical to this role:

  • Communication – Listens well; expresses ideas fluently and logically; is open to input and can be depended on for truthfulness

  • Inspiring and Influencing – Fosters an exchange of ideas and support; persuades and influences without authority

  • Teamwork and Collaboration – Creates atmosphere of openness and trust; collaborates; offers support and encouragement

  • Achieving Results – Is goal directed and persistent; is accountable for meeting commitments; recognizes the contributions of peers

Qualifications

  • Bachelor's degree is preferred

  • A minimum of 3 years reimbursement experience preferred

  • Candidate has the ability to work from home as needed 

  • Candidate has the ability to protect patient privacy in a home work environment

  • Candidate has a comfortable at home work setup (laptop will be provided, external monitor recommended) 

  • Proficient in all aspects of reimbursement preferred (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules)

  • Understands reimbursement/funding resources and how to access these resources

  • Knowledge of managed care industry including government payers

  • Excellent investigational and analytical skills with a proven ability to communicate effectively in both written and verbal format

  • Ability to work collaboratively in a team structure and responsibly delegates next steps to appropriate team members

  • Demonstrates effective problem solving and excellent customer service

  • Exceptional attention to detail and ability to prioritize tasks in a fast-paced environment.

Diversity and Inclusion (D&I) are critical to the success of our company and our impact on society. We believe that by championing diversity of background, thought and experience, we can foster a sense of belonging and provide an environment where every employee feels valued, included, and able to contribute their best for the patients we serve. We’re focused on attracting, retaining, developing and advancing our people to their full potential by rewarding bold ways of thinking and integrating inclusive behaviors into every aspect of our work.

Who We Are

Genentech, a member of the Roche group and founder of the biotechnology industry, is dedicated to pursuing groundbreaking science to discover and develop medicines for people with serious and life-threatening diseases. To solve the world's most complex health challenges, we ask bigger questions that challenge our industry and the boundaries of science to transform society. Our transformational discoveries include the first targeted antibody for cancer and the first medicine for primary progressive multiple sclerosis.

Diversity and Inclusion (D&I) are critical to the success of our company and our impact on society. We believe that by championing diversity of background, thought and experience, we can foster a sense of belonging and provide an environment where every employee feels valued, included, and able to contribute their best for the patients we serve. We’re focused on attracting, retaining, developing and advancing our people to their full potential by rewarding bold ways of thinking and integrating inclusive behaviors into every aspect of our work.

The next step is yours. To apply today, click on the "Apply for this job" button.

Genentech is an equal opportunity employer & prohibits unlawful discrimination based on race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, disability, marital & veteran status. For more information about equal employment opportunity, visit our Genentech Careers page.


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