Pharmacy Reimbursement Coordinator

Job Description

Location: Work From Home – Applicants must reside in Ohio

We are seeking a skilled Pharmacy Reimbursement Coordinator to support a patient access and reimbursement program dedicated to improving medication affordability and continuity of care. This work from home position is ideal for someone who brings a strong understanding of insurance processes, pharmacy operations, and patient support programs. The Pharmacy Reimbursement Coordinator serves as a key contact for patients, providers, and payers, ensuring accurate benefit investigations, prior authorization management, and timely access to prescribed therapies—all while maintaining full HIPAA compliance.

Responsibilities:

• Conduct comprehensive benefit investigations to verify patient coverage and determine eligibility for therapy access.
• Communicate with patients, prescribers, and insurance payers to clarify coverage requirements, resolve benefit discrepancies, and address reimbursement barriers.
• Initiate and follow up on prior authorizations, co-pay assistance, or patient support program enrollments when applicable.
• Document all case activities in detail while maintaining confidentiality and adherence to HIPAA and program guidelines.
• Track payer trends and communicate insights related to delays, denials, or coverage changes.
• Collaborate with internal teams to maintain case progression, ensure timely resolution, and support program improvement initiatives.
• Provide professional, empathetic, and knowledgeable support to patients and healthcare providers throughout the reimbursement process.

Qualifications:

• High school diploma required; associate or bachelor’s degree preferred.
• Minimum of 2 years of recent experience in pharmacy reimbursement, benefit investigation, or patient access support.
• Previous experience in a healthcare, specialty pharmacy, or insurance environment required.
• Strong understanding of commercial, government, and specialty pharmacy benefit structures.
• Excellent communication, organization, and documentation skills.
• Ability to manage confidential information responsibly and in compliance with HIPAA.
• Proficiency in Microsoft Teams, Outlook, Word, and Excel; experience with CRM or case management systems preferred.

Schedule & Work Environment:

• Full-time, work from home position.
• Standard operating hours between 8:00 AM and 8:00 PM EST, Monday through Friday.
• Reliable high-speed internet and a private, HIPAA-compliant home workspace required.

Salary Range: The salary range for this position is $39,500 – $56,000 a year ($19.00 – $27.00 per hour), based on experience.

Interview Process: Selected candidates will participate in a multi-step interview process, which will include a screening call with TalentLNX and one or more virtual interviews with Senior Leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and prohibits discrimination and harassment of any kind. We are dedicated to building a diverse workforce and fostering an inclusive work environment where all employees and candidates are treated with respect and dignity. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or any other protected status under applicable law. We actively seek to recruit, develop, and retain talented individuals from diverse backgrounds, and we encourage all qualified candidates to apply for our job opportunities.