Appeals support officer Job at Randstad (Brisbane)

Field Reimbursement Specialist

Field Reimbursement Specialists (FRSs) are responsible for providing field suppo...

Location

United States

Salary:

88700.00 - 126940.00 USD / Year

Cencora

Expiration Date

Until further notice

Requirements

High School Diploma/GED required
Bachelor's degree or specific Practice Management experience preferred
Project management skills
Experience with extensive travel
Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment
Ability to conduct field-based reimbursement and access support, education, and consultation
Understands the dynamics of Specialty Pharmacy vs. Specialty Distribution
Broad understanding of the physician buy-and-bill model vs. assignment of benefits to alternate sites of care
Experience in revenue cycle, buy and bill (including billing with miscellaneous J-code), formulary, benefit investigations, prior authorization, coding, and appeals processes
Deep understanding of medical and pharmacy benefits/policies

Job Responsibility

Provide field support for patient access to client’s specified products through interaction with the client’s patient support program and provider customers
Provide expertise and advanced skills to resolve complex patient access and provider reimbursement issues
Provide educational services across a variety of healthcare provider sites of care
Work directly with the provider and their office support staff
Interact with other reimbursement and patient support services provided by clients
Plan and engage with customers, leveraging client approved resources, to educate on access and reimbursement topics
Manage daily activities that support appropriate patient access to our client’s products in the provider offices
Work as a liaison to other patient assistance and reimbursement support services offered by our clients
Travel weekly, which could include overnight, to healthcare offices within a designated territory
Educate provider office staff and practice managers on logistics needed to support client product

What we offer

Medical
dental
vision care
comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness
support for working families
backup dependent care
adoption assistance
infertility coverage
family building support
behavioral health solutions

Fulltime

School Officer Manager

Our client is seeking to appoint an enthusiastic, efficient and highly motivated...

Location

United Kingdom , Ilford

Salary:

19.00 - 20.00 GBP / Hour

Randstad

Expiration Date

April 02, 2026

Requirements

Provide administrative support for organising and processing data
Understanding of safer recruitment
Maintain data accuracy and attention to detail
Excellent ICT skills and an ability to manage a website
Knowledge of Arbor preferable, training can be given
Experience in database management
Enhanced child DBS on the update service or willingness to get one
2 recent professional references
Eligibility to work in the UK
Demonstrate a diligent and responsible working attitude

Job Responsibility

Recruitment Support: You will provide administrative support for the recruitment process, including coordinating interview days and assisting with DBS checks, identity verification, qualification checks, and references
Payroll & Census: You will support payroll processing, including handling leaver processes and payroll notifications
Absence Management: You will be the primary point of contact for staff absences, monitoring and recording sickness and other leave requests
Admissions & Appeals: You will support the administration of admission appeals, ensuring all processes are transparent and compliant
General Support: You will provide general business and administrative support as needed by the Senior Leadership Team. This includes undertaking reception and telephone duties, managing post, and responding to emails
Data & Records: You will maintain and update school assessment data in the Arbor system and oversee the student attendance role
Additional Duties: You may be required to act as a First Aider or an examination invigilator

What we offer

A rewarding role where you can make a real difference in the lives of young people
A supportive and collaborative working environment
Dedicated consultant to guide you through the application and support you through-out your journey with Randstad
Access to 'Refer a Friend' bonus worth up to £300 in shopping vouchers

Fulltime

Team Lead – SEND Operations (Appeals)

We are currently recruiting for a Team Lead – SEND Operations (Appeals) to join ...

Location

United Kingdom , Exeter

Salary:

Not provided

Service Care Solutions

Expiration Date

April 12, 2026

Requirements

Strong experience working within SEND services
Proven experience managing or working on SENDIST Appeals
Experience within a local authority SEND team
Leadership or supervisory experience

Job Responsibility

Lead and support officers managing SENDIST Appeals
Provide oversight and direction to EHCP Partners
Work closely with the Head of SEND Operations
Contribute to the local authority’s SEND improvement programme
Ensure effective statutory responses for children and young people with Special Educational Needs and Disabilities (SEND)

Fulltime

Administrative Assistant

We are looking for a dedicated Administrative Assistant to join our team in Alba...

Location

United States , Albany

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in administrative roles, showcasing proficiency in office support tasks
Strong skills in handling inbound calls and managing correspondence effectively
Familiarity with data entry practices and maintaining accurate records
Ability to perform receptionist duties, including managing inquiries and directing calls
Knowledge of workflow systems and processes to ensure smooth operations
Excellent communication skills for interacting with external entities and internal teams
Detail-oriented approach to managing documentation and resolving issues

Job Responsibility

Process incoming mail, including complaint and appeal documents, to ensure proper workflow tracking and timely handling
Review and code documents in workflow management systems for accurate forwarding and processing
Prepare and manage outgoing correspondence, ensuring timely communication of complaint resolutions
Serve as a liaison with regulated entities, maintaining records, sending updates, and following up on pending responses
Identify and resolve workflow errors to maintain operational efficiency
Communicate with consumers and healthcare providers to request additional information for file processing
Perform various clerical tasks to support overall administrative functions

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Senior Field Reimbursement Specialist

Under general supervision of a Senior Manager, the Sr Field Reimbursement Specia...

Location

United States , Remote

Salary:

100700.00 - 155100.00 USD / Year

Cencora

Expiration Date

Until further notice

Requirements

Experience related and progressively responsible in a medical practice, private or third-party reimbursement arena, or pharmaceutical industry in sales, managed care, or clinical support
Experience within healthcare provider support such as a physician practice, patient assistance program or similar pharmaceutical/biological support program experience preferred
Bachelor’s degree preferred
Minimum of 7 years of experience
Candidates must possess a Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment
Ability to effectively manage multiple client relationships and customer
Ability to manage and support external meetings, presentations, and client interactions
Ability to lead and work in a matrix environment
Proven teamwork and collaboration skills with a demonstrated record of accomplishment of working in highly matrixed and cross-functional organizations
Ability to manage multiple tasks, timelines, expenses, and other activities necessary to fulfill the roles and responsibilities of a Field Reimbursement Specialists

Job Responsibility

Plan and engage with customers, leveraging client approved resources, to educate on access and reimbursement topics relevant to assigned client’s product
Track progress and evaluate results of assigned activities
Recommends changes in procedures
Lead or direct more complex projects or certain aspects of projects
Operates with reasonable latitude for un-reviewed action or decision
Work within a matrix environment to collaborate with internal and external stakeholders to secure optimized patient access and provide appropriate education through a focused effort on healthcare providers in community, institutional, and academic medical settings
Manage daily activities that support appropriate patient access to our client’s products in the provider offices and healthcare institutions, working as a liaison to other patient assistance and reimbursement support services offered by our clients
Review patient insurance benefit options with appropriate authorizations
Validate prior authorization requirements
Understanding of Specialty Pharmacy processes

What we offer

medical
dental
vision care
comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness
support for working families
backup dependent care
adoption assistance
infertility coverage
family building support
behavioral health solutions

Fulltime

Field Case Manager

Our team members are at the heart of everything we do. At Cencora, we are united...

Location

Canada , Windsor

Salary:

67000.00 - 102960.00 CAD / Year

Cencora

Expiration Date

Until further notice

Requirements

A Bachelor’s degree in health care or a related discipline
Requires a minimum five (5) years, in the healthcare, pharmaceutical or insurance industry or related experience
Case management experience preferred
Available to travel within an assigned territory, some overnight travel may be required
Valid Driver’s License, current auto insurance policy and access to reliable transportation, for regional travel
Experience and background in various therapeutic areas is an asset
Background in business administration (pharmaceutical) sales and marketing an asset
Knowledge of private and public reimbursement structure, systems, and process
Experience with reimbursement navigation, special authorization, appeals process and conducting field-based reimbursement support and consultation
Strong analytical skills including interpretation of regulation and legislation

Job Responsibility

Practice Management: Customize program elements to meet the needs of assigned prescribing physicians
Review patient status and assist the prescribing physician to complete patient enrolment, prepare payer forms to access public or private coverage by reviewing patient charts, documenting previous therapies and tests in order to complete the payer forms
Identify obstacles to obtaining coverage and channel this information to the Program Manager
Develop strong working relationships with physicians and physician office staff, providing additional office support to ensure smooth maintenance of patients enrolled in the program as needed
Proactively provide assistance to resolve issues with regards to assigned physicians
Provide training to physicians and clinics on program and new initiatives approved by the manufacturer
Acts as a liaison and provide ongoing feedback to the Program Manager based on observations in the field and feedback from physicians as it pertains to quality of services, training, and other areas of importance
Complete all relevant reports (program specific reports, expenses, etc.) as per specified timelines and as per required standards.
Patient Support (Based on program design some Field Case Managers may have limited or no patient interactions): Welcome each patient to the program and capture required patient information
Provide reimbursement payer guidelines to patients and physicians

What we offer

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

Fulltime

Field Case Manager

This is a 12-Month Contract role. Our team members are at the heart of everythin...

Location

Canada , Edmonton

Salary:

Not provided

Cencora

Expiration Date

Until further notice

Requirements

A Bachelor’s degree in health care or a related discipline
Requires a minimum five (5) years, in the healthcare, pharmaceutical or insurance industry or related experience
Case management experience preferred
Available to travel within an assigned territory, some overnight travel may be required
Valid Driver’s License, current auto insurance policy and access to reliable transportation, for regional travel
Experience and background in various therapeutic areas is an asset
Background in business administration (pharmaceutical) sales and marketing an asset
Knowledge of private and public reimbursement structure, systems, and process
Experience with reimbursement navigation, special authorization, appeals process and conducting field-based reimbursement support and consultation
Strong analytical skills including interpretation of regulation and legislation

Job Responsibility

Customize program elements to meet the needs of assigned prescribing physicians
Review patient status and assist the prescribing physician to complete patient enrolment, prepare payer forms to access public or private coverage by reviewing patient charts, documenting previous therapies and tests in order to complete the payer forms
Identify obstacles to obtaining coverage and channel this information to the Program Manager
Develop strong working relationships with physicians and physician office staff, providing additional office support to ensure smooth maintenance of patients enrolled in the program as needed
Proactively provide assistance to resolve issues with regards to assigned physicians
Provide training to physicians and clinics on program and new initiatives approved by the manufacturer
Acts as a liaison and provide ongoing feedback to the Program Manager based on observations in the field and feedback from physicians as it pertains to quality of services, training, and other areas of importance
Complete all relevant reports (program specific reports, expenses, etc.) as per specified timelines and as per required standards
Welcome each patient to the program and capture required patient information
Provide reimbursement payer guidelines to patients and physicians

What we offer

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

Fulltime

Turnaround Document Controls Specialist

The Turnaround Document Controls Specialist provides vital administrative and do...

Location

United States , Superior

Salary:

Not provided

Airswift Sweden

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
5-10 years of experience in an industrial, project, or construction environment
will consider education in lieu of experience
Proven experience managing large volumes of technical documentation (work packages, drawings, reports, etc.)
Familiarity with document control systems, databases, and project management tools
Experience coordinating between multiple teams (planning, operations, contractors, safety, procurement) under tight deadlines
Proficiency in Microsoft Office Suite (Word, Excel, Outlook, SharePoint, Teams)

Job Responsibility

Supports the site TA team as the Admin Assistant and Document Controller
Maintains the turnaround database (TADB) file for the turnaround and supports data entry into the database
Enters initial scope information into the database
Ensures data validity
Updates the database
Provides TADB system training and technical support
Creates IDs and passwords for new users of the TADB
Maintains the turnaround paper and electronic filing systems including drawing files
Supports the development and maintenance of planning data and turnaround package data
Maintains turnaround scope change data (appeals system)

Fulltime

Appeals support officer

Randstad

Location:
Australia , Brisbane

Category:
Office Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
March 25, 2026

Expiration:
April 01, 2026

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Job Description:

Job Responsibility:

Requirements:

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