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Reimbursement Specialist25000631 Other

Bayshore Medical Personnel

Other, Ontario

Reimbursement Specialist25000631 Other

Bayshore Medical Personnel

, Ontario
 
Salary: Information not available
 
County: 39
 

JOB SUMMARY 

Under the supervision of the Reimbursement Team Lead/Manager, the 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 RESPONSIBILITIES 

  • Gather 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 chart
  • Follow-up/advocate until a decision is received to secure coverage for the patient
  • Completes and/or reviews Prior Authorization (PA) or Special Authorization (SA) forms prior to submission to insurers
  • Proactively 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
  • Assist the Specialty Drug Care Program in maintaining federal, provincial, and local laws, accrediting body standards, and Policies and Procedures (P&Ps)
  • Communicates with patients regarding their third party insurance provider, or ODB, to resolved billing issues
  • Communicates with patients’ third party plans, or ODB, to troubleshoot rejected claims
  • Assists the pharmacist in entering prescriptions into the prescription software (Kroll), and filling/billing such prescriptions
  • Participate in ongoing internal and/or external continuing education activities
  • Adhere to Bayshore Policies and Procedures
  • Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System
  • Employee 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.
  • Participates 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 personnel
  • Complete other tasks as requested

 

We are committed to hiring military and Veteran spouses and encourage you to identify your connection with the MSEN when reaching out to us or applying to any of our open roles.

 

Have questions or want to learn more about us? We would love to hear from you!

 Recruitment Team

Email: bmprecruiter@bayshore.ca

 855-272-5700

 

 

About Bayshore Medical Personnel

Bayshore Medical Personnel is honored to support those who have and those who continue to serve and protect our country. Bayshore Medical Personnel is proud to partner with Military Family Services, Canadian Forces Morale and Welfare Services in order to bring quality careers in nursing, pharmacy, occupational health and occupational therapy to the attention of military spouses. Wherever possible BMP will attempt to provide continuous professional employment to spouses as military members are deployed across the country. We understand the resilience required by military spouses to continually seek new employment opportunities while being relocated together with their families, and being away from loved ones during deployment. Positions we recruit include: Pharmacist Pharmacy Assistant Physician (RCMP and VAC) RN Community Health RN Occupational Health RN Primary Care RN Case Manager RN Dental Sedation RN Mental Health RPN/LPN Occupational Therapist

Bayshore Medical Personnel is part of the staffing division of Bayshore HealthCare, one of the largest providers of health care in Canada and has been in business over 50 years. Voted as One of Canada’s Best Employers by Forbes, Bayshore is also a platinum winner of Canada’s Best Managed Companies award since 2006.