Reimbursement Analyst Jobs in USA with Visa Sponsorship
Reimbursement Analysts work in healthcare billing and insurance claims, making them strong candidates for H-1B visa sponsorship. Employers regularly file Labor Condition Applications for this role, and the specialty occupation standard is met through degrees in health information management, accounting, or business administration. For detailed occupation requirements, see the O*NET profile.
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Get Access To All JobsINTRODUCTION
Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
ROLE AND RESPONSIBILITIES
The Access & Reimbursement Pharmacy Specialist will be responsible for the benefit verification research and benefit initiation of pharmacy claims. To ultimately obtain patient access, the role includes ongoing follow up on prior authorizations and appeals. The role also includes identifying and obtaining financial assistance. This position is under direct supervision from the Access & Reimbursement Supervisor. This position relies heavily on the ability to accurately follow directions, thoroughly research, address and communicate prescription insurance coverage requirements as well as a comprehensive knowledge of Medicare, Medicaid and commercial plan structures and standards.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Knowledgeable and proficient in pharmacy benefit structure of all major payer types including government and commercial payers
- Knowledgeable and proficient in the entire pharmacy prior authorization and appeals process for prescriptions medications
- Navigate calls to pharmacy benefit manager to determine and obtain patient benefit structure details, initiate overrides, and obtain contracting requirements
- Completes test claims or electronic verification of benefits when applicable
- Accurately collect the information required for each program and capture the information in a Customer Relationship Management system (CRM) or database
- Coordinates with board licensed healthcare professionals including nurses, pharmacists, or supervised pharmacy interns for information needed to complete Prior Authorizations, Appeals and third-party financial assistance forms
- Follows up with pharmacy plans and third-party financial assistance organizations for general information, status updates and determination details within specified timeframes
- Effectively explains prior authorization and appeal approval or denial details with customers in a way that is easily understood to fit the audience's needs
- Keeps current with the requirements and eligibility criteria for copay assistance from public, private, and non-profit organizations related to assigned programs to assist customers with enrolling into third party financial assistance opportunities when applicable. This includes researching foundations available to support the patients' holistic needs
- Keeps current with existing treatment trends, treatment standards and updated indications related to assigned programs to complete Prior Authorization and Appeal forms
- Maintains a working knowledge of program guidelines, FAQ's, products, and therapeutic areas related to programs within the Frontier Therapies portfolio
- Responsible for reviewing, interpreting, and reacting to data provided by clients and customers
- Coordinates the triage of patient prescription to the appropriate partner for fulfillment or administration
- Communicates customer statuses to the appropriate parties at specified intervals or as needed
- Resolve customer issues through basic troubleshooting and escalate potential problems or issues that require management's attention in a timely manner
- Maintains company, employee and customer confidentiality as well as compliance with all HIPAA regulations
- Provide recommendations to IT partners on system enhancements to better drive performance and quality
- Completes special duties or projects assigned by leadership
WHAT WE OFFER
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
BASIC QUALIFICATIONS
- 2+ years of experience in hands-on Pharmacy Claims Processing experience and Benefit Verification in a pharmacy setting
- Ability to work 8-hour shifts Monday through Friday with a start time between 10:00am-11:00am EST
- Must be 18 years of age OR older
PREFERRED QUALIFICATIONS
- 2+ years of Prior Authorization processing experience in an insurance or pharmacy setting
- Valid license, registration and/or certification, good standing, to practice as a Pharmacy Technician as required by the Board of Pharmacy in the state employed
- Specialty Pharmacy experience
- Pharmacy Accreditation experience
- Previous work history working in a matrixed environment, call center, operations environment
SOFT SKILLS
- Ability to work independently and as a team, and maintain good judgment and accountability
- Demonstrated ability to work well with health care providers
- Meet deadlines and proactively communicates roadblocks
- Speak, listen and write in a clear, thorough and timely manner using appropriate and effective communication tools and techniques
- Strive for thoroughness and accuracy when completing tasks
- Ability to work independently
- Strong knowledge of Internet navigation and research
- Willingness to learn and grow in the position
- Participate in continuous quality improvement activities
- Be a team player and collaborate across functions
- Ability to multitask across different applications and work queues
- All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location, and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
INTRODUCTION
Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
ROLE AND RESPONSIBILITIES
The Access & Reimbursement Pharmacy Specialist will be responsible for the benefit verification research and benefit initiation of pharmacy claims. To ultimately obtain patient access, the role includes ongoing follow up on prior authorizations and appeals. The role also includes identifying and obtaining financial assistance. This position is under direct supervision from the Access & Reimbursement Supervisor. This position relies heavily on the ability to accurately follow directions, thoroughly research, address and communicate prescription insurance coverage requirements as well as a comprehensive knowledge of Medicare, Medicaid and commercial plan structures and standards.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Knowledgeable and proficient in pharmacy benefit structure of all major payer types including government and commercial payers
- Knowledgeable and proficient in the entire pharmacy prior authorization and appeals process for prescriptions medications
- Navigate calls to pharmacy benefit manager to determine and obtain patient benefit structure details, initiate overrides, and obtain contracting requirements
- Completes test claims or electronic verification of benefits when applicable
- Accurately collect the information required for each program and capture the information in a Customer Relationship Management system (CRM) or database
- Coordinates with board licensed healthcare professionals including nurses, pharmacists, or supervised pharmacy interns for information needed to complete Prior Authorizations, Appeals and third-party financial assistance forms
- Follows up with pharmacy plans and third-party financial assistance organizations for general information, status updates and determination details within specified timeframes
- Effectively explains prior authorization and appeal approval or denial details with customers in a way that is easily understood to fit the audience's needs
- Keeps current with the requirements and eligibility criteria for copay assistance from public, private, and non-profit organizations related to assigned programs to assist customers with enrolling into third party financial assistance opportunities when applicable. This includes researching foundations available to support the patients' holistic needs
- Keeps current with existing treatment trends, treatment standards and updated indications related to assigned programs to complete Prior Authorization and Appeal forms
- Maintains a working knowledge of program guidelines, FAQ's, products, and therapeutic areas related to programs within the Frontier Therapies portfolio
- Responsible for reviewing, interpreting, and reacting to data provided by clients and customers
- Coordinates the triage of patient prescription to the appropriate partner for fulfillment or administration
- Communicates customer statuses to the appropriate parties at specified intervals or as needed
- Resolve customer issues through basic troubleshooting and escalate potential problems or issues that require management's attention in a timely manner
- Maintains company, employee and customer confidentiality as well as compliance with all HIPAA regulations
- Provide recommendations to IT partners on system enhancements to better drive performance and quality
- Completes special duties or projects assigned by leadership
WHAT WE OFFER
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
BASIC QUALIFICATIONS
- 2+ years of experience in hands-on Pharmacy Claims Processing experience and Benefit Verification in a pharmacy setting
- Ability to work 8-hour shifts Monday through Friday with a start time between 10:00am-11:00am EST
- Must be 18 years of age OR older
PREFERRED QUALIFICATIONS
- 2+ years of Prior Authorization processing experience in an insurance or pharmacy setting
- Valid license, registration and/or certification, good standing, to practice as a Pharmacy Technician as required by the Board of Pharmacy in the state employed
- Specialty Pharmacy experience
- Pharmacy Accreditation experience
- Previous work history working in a matrixed environment, call center, operations environment
SOFT SKILLS
- Ability to work independently and as a team, and maintain good judgment and accountability
- Demonstrated ability to work well with health care providers
- Meet deadlines and proactively communicates roadblocks
- Speak, listen and write in a clear, thorough and timely manner using appropriate and effective communication tools and techniques
- Strive for thoroughness and accuracy when completing tasks
- Ability to work independently
- Strong knowledge of Internet navigation and research
- Willingness to learn and grow in the position
- Participate in continuous quality improvement activities
- Be a team player and collaborate across functions
- Ability to multitask across different applications and work queues
- All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location, and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
See all 4,387+ Reimbursement Analyst Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Reimbursement Analyst roles.
Get Access To All JobsTips for Finding Visa Sponsorship as a Reimbursement Analyst
Target healthcare systems and insurance companies
Large hospital networks, managed care organizations, and health insurance companies file H-1B petitions for Reimbursement Analysts regularly. These employers have established immigration counsel and existing sponsorship infrastructure, making approvals more predictable than smaller billing firms.
Confirm your degree field matches the role
USCIS requires a specific degree-to-job connection for specialty occupation approval. Health information management, accounting, finance, or healthcare administration degrees align most cleanly. A general business degree may require additional documentation to establish the direct relationship.
Ask about sponsorship before the offer stage
Many healthcare employers sponsor but do not advertise it. Raise the question after a strong first interview, not in your initial application. Framing it as a straightforward process for experienced candidates reduces the chance the conversation ends the opportunity prematurely.
Understand the LCA filing requirement
Your employer must file a Labor Condition Application with the Department of Labor before submitting your H-1B petition. The LCA certifies prevailing wage compliance. Familiarity with this step helps you guide hesitant employers who assume sponsorship is more complicated than it is.
OPT and STEM extension coverage for this role
Reimbursement Analyst roles at healthcare organizations often qualify for STEM OPT extension if your degree is in health informatics or a qualifying data-adjacent field. Confirm your CIP code with your DSO early, as this directly affects your available time before needing H-1B approval.
E-3 and TN visas may apply depending on your nationality
Australian citizens can pursue E-3 visa sponsorship for this role without lottery risk. Canadian and Mexican nationals may qualify under TN status in the accountant or computer systems analyst category depending on specific duties. Both pathways bypass the H-1B cap entirely.
Frequently Asked Questions
Is a Reimbursement Analyst considered a specialty occupation for H-1B purposes?
Yes, Reimbursement Analyst roles generally qualify as specialty occupations when the position requires a bachelor's degree or higher in a specific field such as health information management, accounting, finance, or healthcare administration. USCIS scrutinizes cases where the employer's job posting says a degree is preferred rather than required, so the job description wording matters. Employers with a clear educational requirement in a related field have the strongest petitions.
Which visa types are most common for Reimbursement Analysts seeking sponsorship?
The H-1B visa is the most common path. Australian citizens have strong access to the E-3 visa, which has no lottery and processes at U.S. consulates in Australia within a few weeks. Canadian and Mexican nationals may qualify under TN visa status depending on how their duties are classified. All three options require employer sponsorship, so finding a willing employer is the first step. Browse sponsoring employers on Migrate Mate.
Do Reimbursement Analyst roles typically qualify for STEM OPT extension?
It depends on your degree's CIP code rather than your job title. Degrees in health informatics, health information management, or data-adjacent healthcare fields may qualify. A standard accounting or business administration degree typically does not meet the STEM OPT criteria. Check your degree's CIP code with your Designated School Official before assuming you have 24 additional months of work authorization, as this affects your H-1B timing strategy significantly.
How difficult is it to get H-1B sponsorship as a Reimbursement Analyst?
The specialty occupation bar is generally met for this role, so approval rates at the petition level are reasonable once you clear the lottery. The harder challenge is the lottery itself, which selects roughly 25% of registrations in a given year. Large healthcare employers and hospital systems are more likely to sponsor because they have existing immigration programs. Smaller medical billing companies may not have sponsored before and may be hesitant even when legally straightforward.
What should I include in my job application to improve my chances of sponsorship?
Highlight your degree field explicitly and connect it to the technical nature of the role, such as reimbursement coding, payer contract analysis, or claims adjudication. Employers who understand the specialty occupation connection are more confident sponsoring. If you have prior experience with ICD-10 coding, CPT coding, or payer-specific billing systems, include it. Targeting employers with a documented history of sponsorship is the most efficient approach, and Migrate Mate filters job listings specifically for sponsoring employers.
What is the prevailing wage requirement for sponsored Reimbursement Analyst jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.