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JKElevenEleven

Job Summary We are hiring a full-time Reimbursement Specialist to join the patient services team at a well-established specialty healthcare organization. In this work-from-home role, you will manage the full reimbursement cycle for patients, guiding them through insurance coverage, prior authorizations, and financial assistance so they can start and stay on therapy. You will work closely with payers, internal teams, and provider offices to resolve access barriers and keep cases moving forward.This role requires 4 to 6 weeks of paid on-site training at our Pittsburgh, PA office before transitioning to a permanent remote schedule. All equipment is provided. Scheduling operates on a rotating, flexible basis between 8:00 AM and 8:00 PM, Monday through Friday.If you have a strong reimbursement background, enjoy working independently, and want to be part of a team that directly impacts patient outcomes, we want to hear from you.Responsibilities<ul><li>Serve as a primary point of contact for payer and reimbursement inquiries, managing cases from intake through resolution</li><li>Conduct benefits investigations and verify pharmacy and/or medical insurance coverage</li><li>Manage prior authorization submissions, follow-up communications, denial reviews, and appeals processing</li><li>Communicate frequently with payers to obtain accurate coverage details, authorization status, and plan requirements</li><li>Connect eligible patients with copay assistance programs and available financial support resources</li><li>Identify and resolve access barriers, including coverage delays, denials, underpayments, and step therapy requirements</li><li>Collaborate with internal teams and provider offices to share reimbursement updates and keep patients on track</li><li>Document all patient and payer interactions accurately and in full compliance with patient privacy requirements</li><li>Escalate complex cases appropriately using professional judgment and established protocols</li></ul>Requirements<ul><li>High school diploma required</li><li>Minimum 2 years of direct reimbursement experience including benefits investigation, prior authorizations, and payer communications</li><li>Background in a pharmacy, healthcare, or insurance-related environment</li><li>Understanding of pharmacy and/or medical benefit structures and coverage determination processes</li><li>Ability to manage an independent caseload, prioritize work, and meet defined service levels</li><li>Strong written and verbal communication skills with a focus on accuracy and professionalism</li><li>Must be within commuting distance of Pittsburgh, PA and available to report on-site for the initial 4 to 6 week training period</li><li>Reliable home office setup with stable internet connection required; all equipment provided</li></ul>Preferred Requirements<ul><li>Certified Pharmacy Technician (CPhT) or similar healthcare credential</li><li>Experience with complex or high-cost medications and patient access challenges</li><li>Knowledge of commercial, government, Medicaid, VA, or Federal plan types</li><li>Familiarity with PBMs, copay assistance programs, or patient financial assistance resources</li><li>Background in a patient support, case management, or reimbursement services environment</li><li>Strong analytical and organizational skills with meticulous attention to detail</li></ul>Pay: $20.00 - $30.00 per hourBenefits:<ul><li>401(k) matching</li><li>Dental insurance</li><li>Flexible schedule</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Professional development assistance</li><li>Vision insurance</li><li>Work from home</li></ul>Application Question(s):<ul><li>This role is scheduled as a standard 8-hour shift, with start times falling anywhere between 8:00 AM and 8:00 PM, Monday through Friday, on a rotating basis. Are you available to work any 8-hour shift within that window?</li><li>Are you within commuting distance of Pittsburgh, PA and able to report on-site for an initial 4 to 6 week paid training period?</li><li>Do you have 2 or more years of direct reimbursement experience including benefits investigation, prior authorizations, and payer communications?</li></ul>Work Location: Remote

Reimbursement Specialist

Job Type: Full-time (40 Hours)Work Schedule: Monday &ndash; Friday (Weekends Off)Location: Coraopolis, PAJob Summary: We are looking for a meticulous Pharmacy Data Entry Technician to join our specialty closed-door pharmacy team. In this role, you will be responsible for accurately inputting prescription and patient information into our system, ensuring compliance with industry regulations. If you have experience in pharmacy data entry and fulfillment, combined with strong organizational skills and a sharp eye for detail, we&rsquo;d love to hear from you!Responsibilities:<ul><li>Accurately enter prescription and patient data into the pharmacy management system.</li><li>Manage medication inventory and ensure proper storage and handling of pharmaceuticals.</li><li>Verify prescription details for completeness and adherence to regulatory standards.</li><li>Collaborate with pharmacists and team members to facilitate medication fulfillment and ensure timely order processing.</li><li>Assist in processing prescription refills and conducting data audits as required.</li><li>Address internal and external inquiries regarding prescription and data-related matters.</li><li>Help resolve discrepancies related to prescriptions or data entries to ensure accuracy.</li><li>Participate in quality assurance initiatives to improve operational efficiency and data integrity.</li></ul>Qualifications:<ul><li>High school diploma or GED required; pharmacy technician certification is a plus.</li><li>1+ years of experience in pharmacy data entry and medication fulfillment preferred.</li><li>Familiarity with pharmacy management systems and software (e.g., Epic, QS/1).</li><li>Strong attention to detail and exceptional organizational skills.</li><li>Ability to work independently and effectively manage time in a remote environment.</li><li>Excellent communication skills and a collaborative spirit.</li><li>Knowledge of HIPAA regulations and a commitment to maintaining patient confidentiality.</li></ul>Join our dedicated team and play a vital role in delivering exceptional patient care in our specialty pharmacy!Job Type: Full-timePay: $18.00 - $25.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee discount</li><li>Flexible schedule</li><li>Health insurance</li><li>Opportunities for advancement</li><li>Paid time off</li><li>Vision insurance</li></ul>Physical Setting:<ul><li>Telehealth</li></ul>Experience:<ul><li>Pharmacy technician experience: 2 years (Preferred)</li></ul>Shift availability:<ul><li>Day Shift (Preferred)</li><li>Night Shift (Preferred)</li></ul>Ability to Commute:<ul><li>Coraopolis, PA (Required)</li></ul>Ability to Relocate:<ul><li>Coraopolis, PA: Relocate before starting work (Required)</li></ul>Work Location: In person

Pharmacy Data Entry Technician

Join JKElevenEleven and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

JKElevenEleven

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Reimbursement Specialist

Pharmacy Data Entry Technician