Reimbursement Specialist

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 help patients navigate the often-complex process of securing prescription drug coverage and reimbursement. You'll coordinate with insurance providers, healthcare professionals, pharmacies, and public or private funding programs to identify effective coverage solutions. The role combines customer service, healthcare administration, financial analysis, and detailed case coordination. You'll manage documentation and submissions while ensuring cases progress efficiently and accurately. Strong organization and communication will be essential when balancing multiple cases and competing deadlines. You'll also develop valuable expertise in pharmaceutical reimbursement and healthcare funding mechanisms while contributing to better patient access to needed therapies.

Accountabilities:

• Coordinate and manage the end-to-end processes required to obtain prescription drug coverage and reimbursement for patients.
• Work closely with insurance companies, physician offices, healthcare professionals, pharmacies, and funding organizations to maximize available reimbursement solutions.
• Prepare, coordinate, and submit required documentation, forms, and supporting information to private insurers and public or federal funding programs.
• Conduct financial means testing when required to help identify appropriate coverage and maximize available patient support.
• Coordinate pharmacy-related processes once funding or coverage has been secured, ensuring a smooth transition through the next stages.
• Build and maintain strong knowledge of public, private, and federal drug funding and reimbursement mechanisms.
• Review cases carefully, resolve issues efficiently, and ensure accurate and timely follow-up on outstanding requirements.
• Report adverse events to the appropriate internal teams and departments in accordance with established procedures.
• Maintain professional, courteous, and efficient communication with patients, healthcare professionals, insurers, and internal stakeholders.
• Manage multiple cases and priorities while consistently meeting deadlines, service expectations, and quality standards.
• Contribute to additional operational tasks and initiatives as required, supporting the broader patient and provider services function.

Requirements:

• Post-secondary education or equivalent training in business administration, accounting, healthcare, pharmaceutical services, or another related discipline.
• At least 1–2 years of customer service or office-based experience, with experience in healthcare, pharmaceutical, medical, insurance, or reimbursement environments considered an asset.
• Strong working knowledge of Microsoft Word, Excel, Outlook, PowerPoint, and other standard office applications.
• Knowledge of the pharmaceutical distribution industry and familiarity with automated warehouse or pharmacy operating systems is an asset.
• Strong analytical, mathematical, and financial skills, with the ability to understand and work accurately with reimbursement information.
• Excellent organizational skills, attention to detail, and the ability to manage multiple priorities and competing deadlines.
• Strong problem-solving abilities, with a practical and efficient approach to resolving issues.
• Excellent written and verbal communication skills, with a professional and courteous telephone manner.
• Strong interpersonal and presentation skills, with the ability to communicate effectively with diverse stakeholders.
• Ability to work independently while also contributing effectively within a collaborative team environment.
• Bilingual French/English communication skills are considered an asset.
• A proactive, reliable, detail-oriented approach and a strong commitment to accuracy, confidentiality, and patient service.

Benefits:

• Competitive salary: approximately CAD $39,552–$66,847, depending on experience, qualifications, and other factors.
• Comprehensive health, dental, and vision coverage.
• Benefits and resources supporting physical, emotional, financial, and social well-being.
• Support for working families, which may include backup dependent care, adoption assistance, family-building support, infertility coverage, and caregiver resources.
• Paid parental leave and paid caregiver leave.
• Access to behavioral health and wellness resources.
• Training programs and professional development opportunities to support career growth.
• Mentorship opportunities and access to employee resource groups.
• Opportunities to participate in volunteer and community initiatives.
• A purpose-driven environment focused on improving access to healthcare and supporting patients in obtaining the therapies they need.
• Remote work options across multiple Canadian provinces, subject to role and location requirements.