Pharmacy Claims Processor
Our Company PharMerica Overview Step Into a Rewarding Role as a Claims Specialist with PharMerica! Are you ready to make a real impact in a growing organization? Join our PharMerica team as a Claims Specialist, where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly matters—delivering exceptional care and service. Why Join PharMerica? - Focused on Service Excellence: Our mission is to provide top-quality care and outstanding customer service to hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers across the nation. - Career Growth: We’re in high growth mode, offering plenty of opportunities for those looking to advance their careers. - Remote Flexibility: This position is 100% remote, giving you the freedom to work from anywhere! What You’ll Do: - As a dynamic Claims Specialist, you will: - Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need. - Be a vital part of a team that’s dedicated to enhancing patient care through meticulous claims management and customer service. - Shift: Varying Shifts available between 7:00AM-11:00PM, nights and weekends available as well. What We Offer: - DailyPay - Flexible Schedules - Competitive Pay with Shift Differentials - Health, Dental, Vision, and Life Insurance - Company-Paid Disability Insurance - Tuition Assistance & Reimbursement - Employee Discount Program - 401k Plan - Paid Time Off - Non-Retail, Closed-Door Environment Responsibilities - The Claims Specialist - 3rd Party: Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks - Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines - Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement -