Bilingual Reimbursement Specialist Contract
Bayshore HealthCare
Mississauga, ON, CA
5d ago
source : PostJobFree

This will be a Temporary Full Time Position for 12 MonthsUnder the supervision of the Program Manager the Bilingual Reimbursement Specialist will provide drug coverage support to physicians and patients, follow up on submissions pertaining to obtaining coverage through private and provincial drug plans, ensure patients have access to their prescribed treatments in a timely manner, act as a resource to physicians who are prescribing this medication and provide continuous support for patients for renewals, and coverage changes.

DUTIES AND RESPONSIBILITIESGather all pertinent and appropriate information from the chart to complete the necessary forms (private and / or provincial insurance) in a concise, organized and professional manner.

Liaise and advocate with insurance providers and provincial governments as necessary to determine coverage options.Keep detailed notes in the patient’s electronic chartFollow-up / advocate until a decision is received to secure coverage for the patient.

Completes and / or reviews SA forms prior to submission to insurersProactively offer financial assistance for patients.Act as a resource for program stakeholders, which include physicians, nurses, patients and clinics and the client.

Assist with data integrity / rounds as required.Participate in ongoing internal and / or external continuing education activitiesAdhere to Bayshore Policies and Procedures.

Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management SystemEmployee will maintain relevant level of knowledge of ICH (International Conference on Harmonization), GCP (Good Clinical Practice) and Health Canada GVP (Good Pharmocovigilance Practices) guidelines appropriate to their hired role which is to be provided at time of hire and annually.

With this knowledge the employee will perform the work as required by their assigned function and will be provided with regular updates as required.

Must be able to identify and report AE’s to health Canada, Med Info and enter into source system and third party systemsParticipate in processes relating to regulatory reporting requirementsParticipates in proactive Health & Safety activities while performing all duties.

Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns. Responsible for completing Accident Reports for all direct reports who injure themselves on the job, within 24 hours of the incident.

Maintains confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnelComplete other tasks as requestedREPORTING RELATIONSHIPSReimbursement Support Team Manager or Program ManagerQUALIFICATIONS & EXPERIENCEMinimum 2 years of Canadian public and private reimbursement navigation and advocacy experience, within a patient program environment, ideally with PA / SA drugs for chronic diseases.

Understanding of provincial and private coverage criteriaFamiliarity with the Special Authorization process for both public and private insurance in Quebec.

Strong computer and software skills : Excel, Word, Outlook, Adobe Acrobat, CRM database entry, VOIP telephony, web portals, teleconferences, web-based meetings.

Ease with working independently, playing detective, making decisions using sound judgment, and meeting deadlines.Ease with working in a paperless environment.

Excellent written and verbal communication skills in English and French for positions requiring FrenchFamiliarity with PIPEDA and how it applies in a confidential patient environment.

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