Reimbursement Specialist, CGT
Core
Verify insurance coverage and manage appeals for cell and gene therapies to ensure patient access to life-changing treatments.
Role type
Cell and Gene Therapy Insurance Reimbursement Specialist
Builds
Insurance claim approvals and reimbursement processes for specialty therapies
Domain
Healthcare / Specialty Pharmacy / Cell and Gene Therapies
Deliverable
client delivery
Required skills
Insurance verification, prior authorizations, medical billing, appeals management, compliance with healthcare regulations, patient support, data reporting
Preferred skills
Experience in cell and gene therapies, knowledge of rare disease reimbursement, familiarity with infusion billing
Technologies
Microsoft Office Suite (Word, Excel, PowerPoint)
Responsibilities
Verify patient insurance coverage and benefits for cell and gene therapies; manage appeals and denials for insurance claims; maintain detailed records of reimbursement activities; ensure compliance with evolving insurance regulations; provide guidance to patients and families on coverage options; collaborate with cross-functional teams to streamline reimbursement processes
Seniority
Mid-level, hands-on IC