2h ago

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Reimbursement Specialist

CanadaRemoteFull-timemid

Healthcare ClinicalENT Specialist

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Quick Summary

Key Responsibilities

The opportunity to help patients overcome financial and administrative barriers to accessing essential medications and treatments. Inclusive workplace: A commitment to equal employment opportunities,

Technical Tools

Healthcare ClinicalENT Specialist

As a Reimbursement Specialist, you will play an essential role in helping patients access the prescription medications and specialized treatments they need, particularly those managing rare and complex diseases. You will coordinate reimbursement cases, navigate public and private insurance systems, and work closely with patients, physicians, healthcare professionals, and funding organizations to secure appropriate coverage. Your expertise will help simplify complex reimbursement processes and identify financial assistance solutions that reduce barriers to treatment. You will also manage documentation, assess funding eligibility, and coordinate pharmacy arrangements once coverage is approved. This part-time, remote opportunity combines healthcare knowledge, financial analysis, and patient-focused service in a collaborative pharmaceutical support environment. Your work will directly contribute to improving treatment accessibility and supporting better patient outcomes across Canada.

Coordinate daily activities and maintain regular communication with program managers and associate program managers regarding new and existing patient support projects.

Develop and maintain a thorough understanding of rare disease programs, including disease mechanisms, pathophysiology, therapeutic areas, treatment products, and applicable standard operating procedures (SOPs).

Navigate public, private, provincial, and federal reimbursement systems, as well as funding programs and organizations supporting patients with rare diseases.

Coordinate reimbursement cases with physicians, medical offices, healthcare professionals, insurers, and other relevant stakeholders to obtain the information required for coverage applications.

Manage the end-to-end prescription drug reimbursement process, identifying appropriate funding options and working to secure timely coverage for eligible patients.

Prepare, organize, submit, and follow up on documentation required by insurance companies, public funding programs, federal agencies, and other reimbursement bodies.

Evaluate individual patient circumstances and implement financial means testing when required to identify suitable assistance options and maximize prescription drug coverage.

Navigate complex reimbursement procedures and advocate for appropriate coverage of specialized, high-cost, and potentially life-saving medications.

Coordinate with pharmacies and relevant healthcare partners to facilitate medication access and ensure the necessary processes are completed once funding has been secured.

Communicate sensitively and professionally with patients and healthcare professionals, explaining reimbursement requirements and supporting patients throughout the process.

Maintain accurate case records, monitor outstanding requests, meet established deadlines, and ensure compliance with applicable procedures and documentation standards.

Identify and report all adverse events to the designated internal teams or departments in accordance with established reporting procedures.

Collaborate with colleagues and stakeholders to resolve reimbursement challenges, improve case management efficiency, and support the successful delivery of patient assistance programs.

Perform additional related duties as required to support program objectives and operational needs.

Requirements

~2 min read

At least one year of professional experience in the pharmaceutical, insurance, or healthcare industry.

A minimum of one year of customer service experience, preferably in a healthcare, pharmaceutical support, patient assistance, or insurance environment.

Previous experience in reimbursement coordination and a solid understanding of public, private, and federal prescription drug funding mechanisms are required.

Strong knowledge of pharmaceutical or insurance industry processes, with the ability to understand complex reimbursement requirements and navigate different funding systems.

Excellent verbal and written communication skills in both French and English; bilingual proficiency is mandatory.

A professional, courteous, and efficient telephone manner, with the ability to communicate clearly and compassionately with patients and healthcare professionals.

Strong interpersonal skills and the ability to handle sensitive patient information and financial or medical discussions with discretion, empathy, and professionalism.

Strong analytical and mathematical skills, with the ability to assess financial information, evaluate funding options, and support reimbursement decisions.

Sound business and financial judgment, including the ability to interpret reimbursement criteria and identify appropriate coverage solutions.

Excellent organizational and time-management skills, with the ability to prioritize competing requests, manage multiple cases simultaneously, and meet strict deadlines.

High attention to detail and accuracy when preparing submissions, reviewing documents, updating case records, and following established procedures.

Proficiency in Microsoft Office applications, particularly Outlook, Word, and Excel.

Strong problem-solving skills and the ability to resolve issues efficiently while adapting to changing case requirements.

The ability to work independently while collaborating effectively with program managers, healthcare professionals, insurers, pharmacies, and internal teams.

A patient-centered mindset and commitment to improving access to treatment through responsive, ethical, and reliable reimbursement support.

What We Offer

~2 min read

Part-time employment: A remote opportunity supporting patient reimbursement and specialized healthcare programs.

Health and wellness benefits: Access to medical, dental, and vision coverage, subject to eligibility and applicable employment terms.

Comprehensive wellbeing resources: Programs designed to support physical, emotional, financial, and social wellbeing.

Family support programs: Potential access to backup dependent care, adoption assistance, infertility coverage, family-building support, and caregiver resources, depending on eligibility.

Paid leave programs: Potential access to paid parental leave and paid caregiver leave, subject to applicable policies.

Behavioral health support: Resources and services designed to support mental health and overall wellbeing.

Professional development: Training programs, learning resources, and opportunities to strengthen pharmaceutical reimbursement and patient support expertise.

Mentorship opportunities: Access to professional mentoring and career development initiatives.

Employee resource groups: Opportunities to connect with colleagues, participate in employee communities, and contribute to an inclusive workplace.

Volunteer opportunities: Programs that encourage community involvement and meaningful contributions beyond daily responsibilities.

Purpose-driven work: The opportunity to help patients overcome financial and administrative barriers to accessing essential medications and treatments.

Inclusive workplace: A commitment to equal employment opportunities, accessibility, and reasonable accommodations throughout the recruitment process and employment.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

#LI-CL1

✓Part-time employment: A remote opportunity supporting patient reimbursement and specialized healthcare programs.

✓Health and wellness benefits: Access to medical, dental, and vision coverage, subject to eligibility and applicable employment terms.

✓Comprehensive wellbeing resources: Programs designed to support physical, emotional, financial, and social wellbeing.

✓Family support programs: Potential access to backup dependent care, adoption assistance, infertility coverage, family-building support, and caregiver resources, depending on eligibility.

✓Paid leave programs: Potential access to paid parental leave and paid caregiver leave, subject to applicable policies.

✓Behavioral health support: Resources and services designed to support mental health and overall wellbeing.

✓Professional development: Training programs, learning resources, and opportunities to strengthen pharmaceutical reimbursement and patient support expertise.

✓Mentorship opportunities: Access to professional mentoring and career development initiatives.

✓Employee resource groups: Opportunities to connect with colleagues, participate in employee communities, and contribute to an inclusive workplace.

✓Volunteer opportunities: Programs that encourage community involvement and meaningful contributions beyond daily responsibilities.

✓Purpose-driven work: The opportunity to help patients overcome financial and administrative barriers to accessing essential medications and treatments.

✓Inclusive workplace: A commitment to equal employment opportunities, accessibility, and reasonable accommodations throughout the recruitment process and employment.