Pharmacy Claims Representative

Job Summary

A company is looking for a Pharmacy Claims Representative 2 - Remote.

Key Responsibilities

• Review, analyze, and process pharmacy claims accurately and timely
• Identify discrepancies and investigate claim issues for resolution
• Communicate with pharmacies, providers, and internal teams to clarify information and resolve errors

Required Qualifications

• 1-2 years of pharmacy claims or healthcare operations experience
• Working knowledge of pharmacy billing procedures and third-party payer systems
• Proficiency in claims processing platforms and Microsoft Office tools
• High school diploma required; associate degree preferred
• Experience with pharmacy claims adjudication is required