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CLAIMS SPECIALIST

Company: Pharmerica
Location: Taunton
Posted on: May 15, 2024

Job Description:

Our Company:PharMericaOverview:Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!This position is 100% remote!We offer:DailyPayFlexible schedulesCompetitive payShift differentialHealth, dental, vision and life insurance benefitsCompany paid STD and LTDTuition AssistanceEmployee Discount Program401kPaid-time offTuition reimbursementNon-retail/Closed-door environmentOur Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!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 risksResearches, 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 deadlinesEnsures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursementMonitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processesWorks as a team to identify, document, communicate and resolve payer/billing trends and issuesReviews and works to convert billing exception reports to ensure claims are billed to accurate financial plansPrepares and maintains reports and records for processingPerforms other tasks as assignedQualifications:Education/Learning Experience:Required: High School Diploma or GEDDesired: Associates or Bachelors DegreeWork Experience:Required: Customer ServiceDesired: Up to one year of related experience. Pharmacy Technician experienceSkills/Knowledge:Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office SuiteDesired: Knowledge of the insurance industrys trends, directions, major issues, regulatory considerations and trendsettersLicenses/Certifications:Desired: Pharmacy technician, but not requiredAbout our Line of Business: PharMerica is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica is one of the nation's largest pharmacy companies. PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about PharMerica, please visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn. Additional Job Information:This is an excellent opportunity to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.Salary Range: USD $19.00 - $21.00 / Hourby Jobble

Keywords: Pharmerica, Taunton , CLAIMS SPECIALIST, Other , Taunton, Massachusetts

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