Reimbursement Coordinator, Specialty - GTA (Hybrid)
- Ontario
- Permanent
- Temps-plein
Reports to: Senior Director, Specialty
No. of Positions: 1
ATR: 4836
Type: Full time, Permanent
Salary: Salary, commensurate with experience
Benefits: YesJob Responsibilities:-You will be responsible for the coordination of the patient treatment journey for your assigned patients and/or clinics
-Act as the primary point of contact for physicians to enroll patients into the various patient support programs
-Conduct patient welcome calls to gather relevant information, introduces patients to the support program, and obtains patient consent as required.
-Establish and maintain a strong, trusting relationship with assigned clinics and physicians
-Coordinate reimbursement paperwork and PSP navigation. Main resource to request all information needed from the patient and physician to complete the patient support program forms in a timely manner
-Assists in determining copay responsibly and any coordination of benefits opportunity with patients insurance benefits
-Initiates prior authorizations as required by the patient's health care plan(s)
-Communicates any referral delays or issues to the appropriate escalation contact
-Accurately document all communications and upload all source documents into the SalesForce CRM in a timely manner
-Coordinate patient deliveries within timelines based on secured drug coverage
-Coordinate injection training for patients as needed
-Assist pharmacies to resolve prescription billing and adjudication issues with public and private payers
-Conduct patient follow up calls to confirm adherence, monitor adverse events (AE), and provide bloodwork reminders if needed
-Report all adverse Events (AE) and Product Technical complaints (PTC) immediately upon becoming aware of the event as per policies and procedures
-Foster and build relationships with patients and key health care providers, as well as with internal team members (account manager, pharmacy team, reimbursement team)
-Assist with a variety of scheduled and unscheduled projects that may occur within the department at any given time.Qualifications:-Diploma or certificate in business/medical administration
-Minimum of two years of experience working in a pharmacy setting adjudicating claims
-Pharmacy or healthcare knowledge an asset
-Experience with the prior authorization process for specialty/high-cost medication.
-Experience in navigation Patient Support Programs an asset.
-Proficiency with Kroll Pharmacy Management Software an asset.
-Computer skills including proficiency in MS Office
-Experience working in therapeutic areas such as neurology, allergy and respirology, dermatology, and rheumatology is an assetSkills:
-Interest in working in a developing and expanding role.
-Professional/courteous/efficient telephone manner.
-Ability to work independently and in a team environment.
-Ability to resolve issues effectively and efficiently.
-Critical thinking and problem-solving abilities.
-Excellent interpersonal skills and communication skills - both written and verbal
-Exceptional customer service skills, empathetic to patients needs', proven track record as a patient advocate
-Proven ability to organize time, set priorities, and multi-task to meet various competing requirements.
-Demonstrated attention to details with superior organizational and administrative skillsHuman Resources:While we thank you for your interest, only select applicants will be contacted regarding the position.Royal Drugs is an inclusive and equal opportunity employer committed to providing diversity and accommodations for applicants upon request at any stage of the recruitment process in accordance with the Accessibility for Ontarians with Disabilities Act (AODA) and the Ontario Human Rights Code. All applicants must make their requirements known when contacted.The company reserves the right to close the competition based on business need and a sufficient pool of candidates who have applied.CompanyOMS / Royal DrugsLocationHO -GTAOpening DateJul 18, 2025Closing DateAug 31, 2025RequirementsType Description Status
A&AODA Accessibility & AODA Acknowledment Required within 30 days after job starts
EO -2 Quality & Regulatory Training (Phase 2) Required within 30 days after job starts
EO-1 General Orientation (Phase 1) Required within 30 days after job starts
WHMIS WHMIS 2015 Required within 30 days after job starts
WPVH Workplace Violence and Harassment Required within 30 days after job starts