About this role
Position Overview
We are seeking an experienced Urology Medical Funding, Revenue Cycle & Reimbursement Representative to support patient access, specialty drug funding, reimbursement optimization, payment posting, and financial counseling within a large, growing urology practice.
This role will serve as the primary resource for securing financial assistance, maximizing reimbursement, reconciling funding payments, and ensuring timely access to treatment for patients receiving urologic therapies.
Key Responsibilities
- Manage patient assistance, copay assistance, foundation grants, and manufacturer funding programs.
- Screen patients for eligibility for Medicaid, Medicare assistance programs, and specialty drug funding resources.
- Obtain and track prior authorizations for medications, procedures, and specialty therapies.
- Coordinate reimbursement for urology medications, including buy-and-bill drugs and specialty pharmacy therapies.
- Post and reconcile payments from insurance carriers, foundations, manufacturers, and patients.
- Review and resolve claim denials, underpayments, and reimbursement discrepancies.
- Monitor accounts receivable and support revenue recovery efforts.
- Reconcile drug inventory, reimbursements, and manufacturer replacement programs.
- Generate funding, reimbursement, and revenue cycle reports.
- Educate patients regarding insurance coverage, treatment costs, and available financial assistance.
- Support Financial Counseling
Preferred Experience
- Urology, oncology, specialty pharmacy, or infusion services
- Prior authorizations and insurance verification
- Medical billing and revenue cycle management
- Patient assistance and copay assistance programs
- Payment posting and account reconciliation
- Drug reimbursement and buy-and-bill programs
- Medicare, Medicaid, and commercial insurance reimbursement
Qualifications
- Minimum 5 years of experience in healthcare revenue cycle, reimbursement, medical funding, billing, or patient financial services.
- Working knowledge of CPT, HCPCS, ICD-10, and J-code billing.
- Strong analytical, organizational, and communication skills.
- Proficiency with EHR and practice management systems.