Pharmacy Claims Representative

Job Summary

Pharmacy Claims Representative, this full-time position involves reviewing, analyzing, and processing pharmacy claims in a remote call center environment, ensuring accuracy and compliance with regulatory standards.

Key Responsibilities

• Review, analyze, and process pharmacy claims with accuracy and timeliness
• Identify discrepancies and investigate claim issues to determine resolutions
• Communicate with pharmacies and providers to clarify information and resolve errors

Required Qualifications, Training, and Education

• 1-2 years of pharmacy claims or healthcare operations experience
• Working knowledge of pharmacy billing procedures and insurance verification
• Experience with pharmacy claims adjudication
• High School diploma required; Associate's degree preferred
• Experience working in a pharmacy environment