[Hiring] Reimbursement Specialist REMOTE USA
Position: Reimbursement Specialist
Date Posted: December 28, 2025
Industry: Healthcare / Life Sciences / Patient Support Services
Employment Type: Full Time
Experience: Not Specified (Customer service or call center experience preferred)
Qualification: Associate or Bachelor’s Degree holder preferred, or minimum 4 years of relevant customer service experience
Location: United States, REMOTE
Company: Mercalis
Description:
Mercalis is an integrated life sciences commercialization partner supporting organizations across the entire healthcare value chain. The company is committed to improving patient access to life-changing therapies through innovative, patient-centric solutions while fostering a diverse, inclusive, and collaborative workplace culture.
Mercalis is currently seeking a dedicated Reimbursement Specialist to provide high-quality inbound and outbound phone support while serving as a primary point of contact for patients, caregivers, and healthcare providers. In this role, you will guide patients through reimbursement services and patient support programs, ensuring access to critical treatments by coordinating resources, verifying insurance coverage, and delivering exceptional customer service.
Key Responsibilities:
- Serve as a reimbursement expert handling patient and healthcare provider interactions related to reimbursement, copay assistance, foundation support, PAP programs, and access solutions
- Act as a patient advocate by supporting eligibility checks, enrollment processes, reimbursement workflows, and affordability programs
- Build strong, trusted relationships with patients, payers, and healthcare providers
- Function as a direct contact for providers by delivering accurate program and patient-related information
- Verify insurance coverage, billing requirements, and reimbursement processes for complex pharmaceutical therapies
- Review and validate program enrollment forms for accuracy and data integrity
- Conduct insurance benefit investigations and triage cases in line with program SOPs
- Document case details in case management systems, including benefits communication, prior authorizations, and appeals support
- Understand and explain benefits across private, commercial, and government payer types such as Medicare, Medicaid, VA, and DOD
- Collaborate with Program Managers, internal teams, and client stakeholders to ensure effective service delivery
- Maintain compliance with regulatory standards, confidentiality, and privacy requirements
- Identify and report pharmacovigilance and adverse event information as required
- Support team morale through a positive, professional, and ethical approach
Qualifications:
- Associate or Bachelor’s Degree preferred, or at least 4 years of call center or customer service experience in a service-driven environment
- Strong verbal and written communication skills
- Knowledge of medical insurance terminology, reimbursement processes, healthcare billing, or related experience
- Excellent problem-solving and decision-making abilities
- Strong attention to detail with consistent follow-through
- Ability to multitask and adapt in a fast-paced environment
- Strong interpersonal skills with the ability to work independently and collaboratively
- Empathetic listening skills when engaging with patients and providers
- Reliable attendance and punctuality
- Proficiency with Microsoft Office products
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