Reimbursement Specialist

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Reimbursement Specialist based in Canada. As a Reimbursement Specialist, you will play an essential role in helping patients access the prescription medications and specialized treatments they need, particularly those managing rare and complex diseases. You will coordinate reimbursement cases, navigate public and private insurance systems, and work closely with patients, physicians, healthcare professionals, and funding organizations to secure appropriate coverage. Your expertise will help simplify complex reimbursement processes and identify financial assistance solutions that reduce barriers to treatment. You will also manage documentation, assess funding eligibility, and coordinate pharmacy arrangements once coverage is approved. This part-time, remote opportunity combines healthcare knowledge, financial analysis, and patient-focused service in a collaborative pharmaceutical support environment. Your work will directly contribute to improving treatment accessibility and supporting better patient outcomes across Canada. Accountabilities: - Coordinate daily activities and maintain regular communication with program managers and associate program managers regarding new and existing patient support projects. - Develop and maintain a thorough understanding of rare disease programs, including disease mechanisms, pathophysiology, therapeutic areas, treatment products, and applicable standard operating procedures (SOPs). - Navigate public, private, provincial, and federal reimbursement systems, as well as funding programs and organizations supporting patients with rare diseases. - Coordinate reimbursement cases with physicians, medical offices, healthcare professionals, insurers, and other relevant stakeholders to obtain the information required for coverage applications. - Manage the end-to-end prescription drug reimbursement process, identifying appropriate funding options and working to secure timely coverage for eligible patients.

- Prepare, organize, submit, and follow up on documentation required by insurance companies, public funding programs, federal agencies, and other reimbursement bodies. - Evaluate individual patient circumstances and implement financial means testing when required to identify suitable assistance options and maximize prescription drug coverage. - Navigate complex reimbursement procedures and advocate for appropriate coverage of specialized, high-cost, and potentially life-saving medications. - Coordinate with pharmacies and relevant healthcare partners to facilitate medication access and ensure the necessary processes are completed once funding has been secured. - Communicate sensitively and professionally with patients and healthcare professionals, explaining reimbursement requirements and supporting patients throughout the process. - Maintain accurate case records, monitor outstanding requests, meet established deadlines, and ensure compliance with applicable procedures and documentation standards. - Identify and report all adverse events to the designated internal teams or departments in accordance with established reporting procedures. - Collaborate with colleagues and stakeholders to resolve reimbursement challenges, improve case management efficiency, and support the successful delivery of patient assistance programs. - Perform additional related duties as required to support program objectives and operational needs. Requirements: - At least one year of professional experience in the pharmaceutical, insurance, or healthcare industry. - A minimum of one year of customer service experience, preferably in a healthcare, pharmaceutical support, patient assistance, or insurance environment. - Previous experience in reimbursement coordination and a solid understanding of public, private, and federal prescription drug funding mechanisms are required.