Remote Pharmacy Claims Specialist

Job Summary

Experienced in medical claims processing, the full-time Remote Pharmacy Claims Specialist will manage inbound and outbound calls, process prior authorization requests, and verify insurance eligibility while working from home on a contract basis.

Key responsibilities:

• Handle inbound and outbound calls related to claims processing
• Process prior authorization requests and verify insurance eligibility and benefits
• Coordinate with providers, pharmacies, and insurance companies to ensure accurate documentation

Required qualifications:

• 1+ year of recent experience in medical benefits, claims, billing, or prior authorizations
• Knowledge of medical terminology, insurance claims, and benefits verification
• Strong communication and customer service skills
• Ability to manage multiple tasks in a fast-paced environment
• High-speed internet with modem access required (hotspots not accepted)