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); Current licensure with the Virginia State Board of Pharmacy
• Licensure/Certification Preferred: Additional supervisory or leadership certifications a plus
• Minimum Qualifications: Minimum of three (3) years of experience as a Reimbursement Specialist or equivalent role; Previous experience supervising or mentoring staff

Other Knowledge, Skills And Abilities

• Required: Strong knowledge of PAPs, prior authorizations, and insurance benefit investigations; Proficiency in EMR systems and Microsoft Office
• Preferred: Strong leadership and communication skills; Ability to handle multiple priorities and high-volume workload; Ability to work in a fast-paced environment; Ability to adapt to frequent change

Physical Requirements

• Physical Demands: Lifting/Carrying (0-50 lbs.), Bending, Sitting, Walking, Standing, 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
• Physical Requirements: 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
• Hazards: Mental/Sensory – Emotional: 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