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Reimbursement Case Jobs (NOW HIRING)

CareMetx LLC

Reimbursement Case Manager

Reimbursement Case Manager POSITION SUMMARY: Under the general supervision of the operational program leadership, the Reimbursement Case Manager is responsible for customer service and case ...

CareMetx

Reimbursement Case Manager

Bethesda, MD · On-site

Reimbursement Case Manager POSITION SUMMARY: Under the general supervision of the operational program leadership, the Reimbursement Case Manager is responsible for customer service and case ...

CareMetx

Reimbursement Case Manager

Bethesda, MD · On-site

Reimbursement Case Manager POSITION SUMMARY: Under the general supervision of the operational program leadership, the Reimbursement Case Manager is responsible for customer service and case ...

giftHEALTH Inc

Lead Reimbursement Analyst

Columbus, OH · On-site

$31.47 - $39.34/hr

Advanced Reimbursement & Case Management Serve as the primary point of contact for moderate to complex reimbursement cases including insurance benefit investigations, prior authorizations, appeals ...

Vaco LLC

Reimbursement Support Specialist

Winter Park, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Maitland, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Longwood, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Orlando, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Apopka, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Lake Mary, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Orlando, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Orlando, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Orlando, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Orlando, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

Vaco LLC

Reimbursement Support Specialist

Orlando, FL · Hybrid

$20 - $22/hr

Specialty pharmacy PBM experience Insurance or reimbursement hub services Healthcare reimbursement/case management Schedule Requirements: Hybrid Schedule Must be available to work any shift between 8 ...

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Reimbursement Case information

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How much do reimbursement case jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for reimbursement case in the United States is $24.76, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $26.92 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Reimbursement Case Specialist, and why are they important?

To thrive as a Reimbursement Case Specialist, you need a solid understanding of medical billing, insurance processes, and healthcare reimbursement policies, typically supported by experience in healthcare administration or a related field. Familiarity with claims management systems, electronic health records (EHRs), and knowledge of coding standards like ICD-10 and CPT is essential. Strong attention to detail, problem-solving abilities, and effective communication skills help in resolving reimbursement issues and working with patients and insurers. These competencies ensure accurate and timely reimbursement, minimize claim denials, and facilitate smooth operations in healthcare financial management.

What is a Reimbursement Case Specialist?

A Reimbursement Case Specialist is a professional who helps patients, healthcare providers, and insurance companies navigate the process of obtaining coverage and reimbursement for medical treatments, medications, or services. They review patient cases, verify insurance benefits, submit claims, and resolve issues related to denied or delayed payments. Their work ensures that patients receive the financial support they need for their healthcare while helping providers receive timely payment for their services.

What are some common challenges faced by Reimbursement Case Specialists, and how can they be effectively managed?

Reimbursement Case Specialists often encounter challenges such as navigating complex insurance policies, managing high caseloads, and ensuring timely communication between healthcare providers, patients, and payers. Staying organized and up-to-date on payer requirements is essential for success in this role. Building strong relationships with both internal teams and external contacts can help streamline case resolution and improve outcomes for patients.

What is the difference between Reimbursement Case vs Medical Billing Specialist?

AspectReimbursement CaseMedical Billing Specialist
Required credentialsKnowledge of insurance policies, coding, and reimbursement proceduresMedical coding certifications, billing software proficiency
Work environmentHealthcare facilities, insurance companies, or billing agenciesHospitals, clinics, or physician offices
Employer usageHandling insurance claims and reimbursement processesProcessing patient bills and coding services

Reimbursement Case professionals focus on managing insurance claims and ensuring proper reimbursement, often requiring knowledge of insurance policies and reimbursement procedures. Medical Billing Specialists primarily handle billing, coding, and submitting claims for healthcare providers. While both roles involve billing and coding, Reimbursement Cases are more centered on insurance reimbursement processes, whereas Medical Billing Specialists focus on patient billing and coding accuracy.

More about Reimbursement Case jobs
What are the most commonly searched types of Reimbursement Case jobs? The most popular types of Reimbursement Case jobs are:
What job categories do people searching Reimbursement Case jobs look for? The top searched job categories for Reimbursement Case jobs are:
Reimbursement Case jobs near you
Reimbursement Case Manager

Reimbursement Case Manager

CareMetx LLC

Remote

Full-time

Medical

Posted 3 days ago

CareMetx rating

6.3

Company rating: 6.3 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

163rd of 203 rated it services

Job description

Job Type
Full-time
Description
From intake to outcomes, CareMetx is dedicated to delivering industry-leading patient access solutions and support services that help patients quickly start and stay on specialty therapy treatments. We provide scalable, efficient digital hub services for pharmaceutical companies and healthcare providers, streamlining workflows with seamless integration for patient enrollment, consent, and prior authorization. Our best-in-class patient support services enhance every step of care, connecting patients, providers, and brands to drive better outcomes and accelerate time-to-therapy.
JOB TITLE: Reimbursement Case Manager
POSITION SUMMARY:
Under the general supervision of the operational program leadership, the Reimbursement Case Manager is responsible for customer service and case management. The Reimbursement Case Manager will work interactively with patients, healthcare providers, pharmacies, and manufacturer clients. The team will also support various reimbursement and patient assistance functions. The Reimbursement Case Manager responds to all patient, and provider account inquiries. Documents all interactions into the CareMetx Connect system in compliance with HIPAA regulations.
PRIMARY DUTIES AND RESPONSIBILITIES:
  • Acts as a single point of contact and voice for all providers and patients. Works as a patient advocate and always demonstrates compassion
  • Serves as a patient advocate and enhances the caller/contact experience
  • Coordinates access to therapies, conducts appropriate follow up and facilitates access to appropriate support services
  • Manages case load depending on the parameters of the program
  • Collects and review all patient information, to the degree authorized by the SOP of the program
  • Validates completeness of all required information and provides assistance to provider and/or patient
  • Provide guidance to physician office staff and patients on how to complete and submit all necessary program applications in a timely manner
  • Determines patient's eligibility and conducts patient enrollment activities (example patient assistance programs and copay assistance)
  • Performs reimbursement related activities such as benefit investigations, prior authorizations, appeals, etc.
  • Provide exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly
  • Maintain frequent phone contact with patients, provider representatives, third party customer service representatives and pharmacy staff
  • Provides reimbursement information to providers and/or patients
  • Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)
  • Coordinate with inter-departmental associates as necessary
  • Work on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercise judgment within defined standard operating procedures to determine appropriate action
  • Typically receives little instruction on day-to-day work, general instructions on new assignments
  • Extensive knowledge of HIPAA regulations and follows all company policies
  • Maintain regular and reliable attendance, including being present, on time, and prepared for work as scheduled.
  • Performs other related duties as assigned.

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
  • Previous 3+ years of experience in a specialty pharmacy, medical insurance, reimbursement hub experience, physician's office, healthcare setting, and/or insurance background preferred
  • Bachelor's Degree Preferred

MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
  • Excellent verbal and written communication skills
  • Ability to multi-task and adapt to changing priorities
  • Proficient keyboard skills
  • Competency in MS Word and Excel
  • Knowledge of HIPAA regulations
  • Detailed oriented and highly organized
  • Excellent interpersonal skills
  • Knowledge of pharmacy benefits, and medical benefits
  • Global understanding of commercial and government payers preferred
  • Ability and initiative to work independently or as a team member
  • Ability to problem solve
  • Customer satisfaction focused

PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • While performing the duties of this job, the employee is regularly required to sit
  • The employee must occasionally lift and/or move up to 10 pounds.

WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
SCHEDULE:
  • Must be flexible on schedule and hours
  • Overtime may be required from time to time
  • Must be willing to work weekends if required to meet company demands

CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.
At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.
CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.

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