Pharmacy Claims Specialist

Job Summary

Working remotely in a full-time capacity, the Pharmacy Claims Specialist will manage and resolve pharmacy claims efficiently, ensuring clients receive necessary pharmaceutical support while enhancing patient care through meticulous claims management.

Key responsibilities

• Manages and identifies rejected pharmacy claims to ensure maximum payer reimbursement and timely billing
• Researches and resolves rejected claims by collaborating with national Medicare D plans and third-party insurance companies
• Prepares and maintains reports and records for processing while monitoring and resolving at-risk revenue associated with billing processes

Required qualifications

• High School Diploma or GED required; Associate's or Bachelor's Degree desired
• Customer service experience required; up to one year of related experience preferred
• Ability to retain and apply a large amount of information in a fast-paced environment
• Basic math aptitude and proficiency in Microsoft Office Suite required
• Pharmacy technician experience or knowledge of pharmaceuticals is a strong preference