New 
USA-Documentation Specialist II (Administrative)
 Spectraforce Technologies | |
medical insurance
| |
 United States, Massachusetts, Cambridge | |
 Oct 30, 2026 | |
| Job Title: Reimbursement Support SpecialistReports To: Director, Case Management Rare Blood DisordersAbout the JobSanofi's Rare Blood patient support program is for people living with rare blood disorders, offering financial assistance, education, and access help throughout their Sanofi prescribed therapy journey. The patient support organization consists of field teams that provide education to patients and health care providers to help patients start and stay on treatment as prescribedThe Reimbursement Support Specialist (RSS) will support and work collaboratively with Case Managers to facilitate the reimbursement process for our product portfolio. This role is an essential part of the case management process that requires a high level of organization and strong communication skills. The Reimbursement Support Specialist follows standardized workflows as defined by management. This is a skilled position that requires customer service, medical billing and/or healthcare insurance reimbursement experience. The RSS role is a support services function within a patient program and is not a patient-facing role.Job Responsibilities:Verify current insurance coverage policies and benefit details through direct contact with medical insurance providers and ensure prompt return of accurate information to facilitate the initiation and ongoing continuity of treatmentResearch and identify insurance company prior authorization processes and provide necessary documents and requirements to Case Management team membersFollow up with payers to determine status of prior authorizations for enrolled patientsRe-verify insurance benefits as needed for the patientsResearch denied and incomplete claims to address potential barriers impacting access to continued treatmentTrack and follow up on in-process claims and denials to the point of resolution providing ongoing cross functional updatesAssist Patient Support Services team in the resolution of copay claim issues related to Sanofi Copay Assistance ProgramProcess new enrollment formsProvide quality phone customer service to inbound callersCoordinate with the Reimbursement Support Specialist team to efficiently assign and distribute tasks from the shared work queueMaintain up-to-date knowledge of the reimbursement process, billing/coding guidelines, dose calculations, healthcare policy, insurance plans, payer trends, financial assistance programs, and related resourcesComplete daily documentation of all interactions and input accurate data on each individual cases, their insurance, coverage approvals and ongoing coverage requirements in CRM Database while maintaining compliance with HIPAA and other regulating bodies as requiredEstablish proficiency and full understanding of Sanofi Patient Support Services Customer Relationship database including undertaking of data elements, case statuses and outcomes, and documentation requirementsEnsure full compliance with Sanofi policies, procedures, and guidelines[strong style="box-sizing: inherit; margin: 0px; padding: 0px;"]Minimum Requirements:AA Degree required, Bachelors Degree preferred1-3 years' experience in health insurance reimbursement or equivalent applicable work experience preferredDemonstrated ability to handle sensitive and confidential information, including patient personal data (PII/PHI), with discretion and care at all timesEffective communication, problem-solving and negotiation skillsAbility to think critically and problem solve to address customer needsAbility to work in a fast-paced environmentExperience working in a high-volume patient services program preferredExperience with Salesforce CRM preferredProficient with MS Word, MS Excel, and MS PowerPointWorking hours may vary based on business needs and team coverage Enable Skills-Based Hiring No Reason for Open Position Open PositionShifttry { var fgTooltip = new FG.Tooltip({ element: $('#cf_descz20042115485961619725907'), text: "Select\x201st\x20\x28Day\x29,\x202nd\x20\x28Mid\x2Dday\x29\x20or\x203rd\x20\x28Night\x29\x20shift\x20from\x20the\x20drop\x20down."}).initialize();} catch(err) {} 1stWork Scheduletry { var fgTooltip = new FG.Tooltip({ element: $('#cf_descz20042023521555613508907'), text: "Enter\x20start\x20and\x20stop\x20times\x20and\x20work\x20days\x20for\x20assignment,\x20\x28Ex\x3A\x209\x20\x2D\x205\x20EST\x3B\x20Mon\x20\x2D\x20Fri\x29."}).initialize();} catch(err) {} Mon-Fri 9am-5pm ESTBackground Check Package US/Canada: Standard Background CheckWill this person work onsite, hybrid or remote for the entire assignment? 100% RemotePre-ID Candidate Name (No Value)Pre-ID Supplier Name (No Value) | |