Reimbursement Specialist Supervisor - Remote

**Remote to Virginia ONLY! Must have active VA Pharmacy and PTCB license in good standing**

The Reimbursement Specialist Supervisor oversees the daily operations of the Reimbursement Specialist team to ensure timely and accurate processing of prior authorizations, insurance follow-ups, and patient assistance program requests pertaining to high-cost medications that require prior authorization. This role provides guidance, coaching, and performance management for team members, while supporting workflow optimization and departmental revenue collection goals.

Essential Job Statements

• Supervise, coordinate, and prioritize the workflow of Reimbursement Specialists across multiple clinics.

• Provide direct line supervision for Reimbursement Specialists, including performance evaluations, disciplinary action, time/attendance, coordination of staff activities, or other work as needed. Conduct hiring, interviewing, onboarding, and training of new employees.

• Monitor team productivity and compliance with turnaround times, providing feedback and coaching as needed.

• Facilitate training and onboarding of new Reimbursement Specialists.

• Review complex or escalated prior authorizations and appeals, ensuring appropriate documentation and

• compliance with insurance and regulatory requirements.

• Collaborate with providers, nursing staff, and the Patient Assistance Program (PAP) team to ensure patients receive timely access to medications.

• Identify process improvements to optimize team efficiency and patient care outcomes.

• Prepare and review reports on team performance, Patient Assistance (PA) approvals/denials, and workload metrics.

• Ensure compliance with departmental and health system policies and regulatory requirements.

• Participate in special projects and cross-functional initiatives as assigned.

• Serve as a point of contact for internal and external escalations related to PAs, appeals, or patient access concerns.

• Performs other duties as assigned and/or participates in special projects to support the mission of VCUHS and the Department. Provides assistance to team members. Accepts alternate assignments, as required.

Patient Population

Not applicable to this position.

Employment Qualifications

Required Education:

High School Diploma or equivalent

Preferred Education:

Associate’s Degree or higher in Business, Healthcare Administration, or related field

Licensure/Certification Required:

Current certification by the Pharmacy Technician Certification Board (PTCB) Current licensure with the Virginia State Board of Pharmacy

Licensure/Certification Preferred:

Additional supervisory or leadership certifications a plus

Minimum Qualifications

Years and Type of Required Experience ·

Minimum of three (3) years of experience as a Reimbursement Specialist or equivalent role

Previous experience supervising or mentoring staff

Other Knowledge, Skills and Abilities Required:

Strong knowledge of PAPs, prior authorizations, and insurance benefit investigations

Proficiency in EMR systems and Microsoft Office

Cultural Responsiveness

Other Knowledge, Skills and Abilities Preferred:

Strong leadership and communication skills

Ability to handle multiple priorities and high-volume workload

Working Conditions

Periods of high stress and fluctuating workloads may occur.

General office environment.

May be exposed to high noise levels and bright lights.

May have periods of constant interruptions.

Prolonged periods of working alone.

Physical Requirements

Physical Demands: Lifting/ Carrying (0-50 lbs.), Bending

Work Position: Sitting, Walking, Standing

Additional Physical Requirements/ Hazards

Physical Requirements: Manual dexterity (eye/hand coordination), Perform shift work, Hear alarms/telephone/tape recorder, Reach above shoulder, Repetitive arm/hand movements, Finger Dexterity, Color Vision, Acuity - far, Acuity - near

Hazards:

Mental/Sensory – Emotional  

Mental / Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Write Legibly, Reading, Logical Thinking

Emotional: Fast-paced environment, Steady Pace, Able to Handle Multiple Priorities, Frequent and Intense Customer Interactions, Noisy Environment, Able to Adapt to Frequent Change

Compensation Range

$25.03 - $38.79

Actual salary offers will be based on several key factors to include relevant work experience, credentials, and qualifications.

EEO Employer/Disabled/Protected Veteran

About Us

Who We Are

Inventing better care, day by day by discovery

Sound outrageous? It absolutely is. Sound impossible? That’s never stopped us before. Sound like hard work, intense research, collaboration with experts around the world, sheer brainpower meets unrelenting willpower? That’s. Exactly. Right.

We’ll do whatever it takes to offer the best in care and empower the best in quality of life. And it’s an approach that works — whether it’s a patient who undergoes a new, life-saving procedure or a clinical researcher who finds promise in a new cancer treatment, exciting new medicine is happening at VCU Health.

We have it all:
• One college and four health sciences schools
• An academic medical center
• A Level I trauma center
• One of only two NCI-designated cancer centers in Virginia
• The region’s only full-service children’s hospital
• More than 800 physicians in 200 specialties
• With a community health center, dedicated research teams, facilities and valued partners in every field

Our medical teams are top notch. And we’re not too shy to boast of internationally known physicians, some recognized as the best in the country, top-ranked local specialists and all-around all-stars at every level. From our very first years to our most recent advancements, we are driven to learn more, dig deeper, teach passionately and never rest in order to be a true leader in discovering what’s possible in health and recovery. We are a comprehensive system of care and a pioneer of health. Read VCU Health Year In Review for more about our accomplishments.