This is a Fully Remote Job
About Our Client:
ConnectMed360 operates in the healthcare sector, focusing on supporting community, oncology, and hematology physicians, patients, payers, and manufacturers. The organization addresses challenges related to patient care coordination and benefits management for individuals battling cancer and rare diseases, aiming to improve outcomes in these specialized medical fields.
About the Opportunity:
The PROGRAM SUPPORT SUPERVISOR plays a critical role in overseeing the accuracy and timeliness of billing, prescription fulfillment, and benefits investigations within the program. This position ensures compliance with regulations and supports operational efficiency, directly impacting patient service quality and the organization’s financial processes.
Responsibilities:
Manage verification of coverage with third-party payers and obtain necessary authorizations
Resolve billing issues including claim resubmissions, coverage changes, and adjustments
Ensure prescriptions comply with Medicare/DMEPOS regulations and proper documentation
Communicate with clients and patients regarding billing inquiries and financial assistance
Coordinate with manufacturer sales representatives and participate in related conference calls
Oversee accurate record-keeping and information flow between billing, accounts receivable/payable, and customer service departments
Generate and analyze reports
Assist in developing and updating prescription fulfillment policies and procedures
Ensure compliance with laws, regulations, and accreditation standards; implement best practices
Delegate responsibilities to ensure timely and accurate fulfillment of tasks
Support pharmacy and medical case completion when needed
Manage and train staff involved in benefits investigations
Monitor daily calls, cases, and chats
Perform other duties as assigned
Adhere to the organization's Code of Business Conduct and Ethics, policies, and applicable laws
Requirements:
Associate’s Degree or equivalent from a two-year college, technical school, or certificate program in pharmacy and/or healthcare
Minimum of two years’ pharmacy experience
Registration/Certification with Board of Pharmacy as required by law
Ability to organize, plan team activities, delegate, provide superior customer service, and use accounting and billing software
Pay Range and Compensation Package:
Starting salary: $65,000 and up depending on experience
Benefits & Perks:
Medical insurance
Dental insurance
Vision insurance
401(k) with match
Paid Time Off and Paid Holidays
Quarterly Incentive Bonuses
Tuition Reimbursement
Company-paid life, short-term, and long-term disability insurance
Equal Opportunity Statement:
Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.