Reimbursement Specialist Supervisor - Remote

Essential Job Statements

• Supervise, coordinate, and prioritize the workflow of Reimbursement Specialists across multiple clinics.
• Provide direct line supervision for Reimbursement Specialists, including performance evaluations, disciplinary action, time/attendance, coordination of staff activities, or other work as needed.
• Conduct hiring, interviewing, onboarding, and training of new employees.
• Monitor team productivity and compliance with turnaround times, providing feedback and coaching as needed.
• Facilitate training and onboarding of new Reimbursement Specialists.
• Review complex or escalated prior authorizations and appeals, ensuring appropriate documentation and compliance with insurance and regulatory requirements.
• Collaborate with providers, nursing staff, and the Patient Assistance Program (PAP) team to ensure patients receive timely access to medications.
• Identify process improvements to optimize team efficiency and patient care outcomes.
• Prepare and review reports on team performance, Patient Assistance (PA) approvals/denials, and workload metrics.
• Ensure compliance with departmental and health system policies and regulatory requirements.
• Participate in special projects and cross-functional initiatives as assigned.
• Serve as a point of contact for internal and external escalations related to PAs, appeals, or patient access concerns.
• Provides assistance to team members. Accepts alternate assignments, as required.

Patient Population

Not applicable to this position.

Employment Qualifications

• Required Education: High School Diploma or equivalent
• Preferred Education: Associate’s Degree or higher in Business, Healthcare Administration, or related field
• Licensure/Certification: Required - Current certification by the Pharmacy Technician Certification Board (PTCB)
• Licensure/Certification: Required - Current licensure with the Virginia State Board of Pharmacy

Additional Qualifications

• Years and Type of Required Experience: Minimum of three (3) years of experience as a Reimbursement Specialist or equivalent role
• Previous experience supervising or mentoring staff

Knowledge, Skills and Abilities

• Strong knowledge of PAPs, prior authorizations, and insurance benefit investigations
• Proficiency in EMR systems and Microsoft Office
• Cultural Responsiveness
• Strong leadership and communication skills
• Ability to handle multiple priorities and high-volume workload
• Ability to work in a general office environment

Physical Requirements

• Periods of high stress and fluctuating workloads may occur.
• General office environment.
• May be exposed to high noise levels and bright lights.
• May have periods of constant interruptions.
• Prolonged periods of working alone.
• Physical Demands: Lifting/Carrying (0-50 lbs.), Bending
• Work Position: Sitting, Walking, Standing
• Additional Physical Requirements/Hazards: Manual dexterity (eye/hand coordination), Perform shift work, Hear alarms/telephone/tape recorder, Reach above shoulder, Repetitive arm/hand movements, Finger Dexterity, Color Vision, Acuity - far, Acuity - near
• Mental/Sensory – Emotional: Mental / Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Write Legibly, Reading, Logical Thinking
• Emotional: Fast-paced environment, Steady Pace, Able to Handle Multiple Priorities, Frequent and Intense Customer Interactions, Noisy Environment, Able to Adapt to Frequent Change

Compensation

• Compensation Range: $25.03 - $38.79
• Actual salary offers will be based on several key factors to include relevant work experience, credentials, and qualifications.