Copay Assistance Clerk

Job Description

Job Description

About AmeriPharma

AmeriPharma is a highly rated closed-door pharmacy making a positive impact on the lives of our patients every day. Our family of brands provides long-term pharmacy care at home. That includes nursing services with CorsanaCare, AmeriPharma Infusion Centers, AmeriPharma Specialty Care, and MedBox, a pharmacy made for seniors.

We're looking for candidates who want to grow with us as our customer demand grows. We're constantly improving the way we work, investing in innovative technology for our future, and striving to modernize pharmacy operations – a rare thing in our industry.  If you want to grow your career in a supportive and transparent environment where people are respected, customers come first, and effort is recognized, this might be the role for you.

AmeriPharma’s Benefits

• Full benefits package including medical, dental, vision, life that fits your lifestyle and goals
• Great pay and general compensation structures
• Employee assistance program to assist with mental health, legal questions, financial counseling etc.
• Comprehensive PTO and sick leave options
• 401k program
• Plenty of opportunities for growth and advancement
• Company sponsored outings and team-building events
• Casual Fridays 

Position Summary
The Copay Assistance Clerk supports the Specialty Pharmacy and Home Infusion Financial Assistance Dept by assisting with administrative and reimbursement-related functions associated with manufacturer copay assistance and foundational programs claims processing. This role works closely with the Revenue Cycle Data & Process Specialist and Copay Assistance teams to ensure timely claim submission, payment follow-up, and accurate documentation to support reimbursement operations and continuity of patient care.

Job Details

• Location: In-person in Laguna Hills, CA
• Schedule: Monday-Friday 6:30AM - 3:00PM PST

Essential Duties and Responsibilities

• Generate and prepare CMS-1500 claim forms for submission to copay assistance programs, payors, and other reimbursement entities.
• Contact payors, copay card vendors, and reimbursement support programs to obtain claim, payment, and denial status updates.
• Document account activity, claim status, and follow-up actions accurately within applicable systems.
• Assist with payment tracking, reconciliation, and identifying outstanding balances or unresolved claims.
• Support copay billing operations related to specialty pharmacy and home infusion services.
• Maintain organized records and ensure supporting documentation is complete and compliant.
• Collaborate with Revenue Cycle teams to resolve billing-related issues.
• Assist with administrative tasks including faxing, scanning, data entry, correspondence, and reporting as assigned.
• Escalate reimbursement concerns, trends, or unresolved issues to the FA leadership team appropriately.
• Maintain confidentiality and comply with HIPAA and all applicable regulatory requirements.
• Perform additional duties and special projects as assigned. 

Qualifications

• High school diploma or equivalent required.
• Familiarity with EOBs (Explanation of Benefits) and medical billing processes. 
• Knowledge of healthcare operations and reimbursement processes. 
  
• Strong attention to detail and organizational skills. 
• Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
• Effective verbal and written communication skills.
• Proficient in Microsoft Office applications and basic data entry functions. 
• Ability to work independently and collaboratively within a team environment. 
• Minimum of 6 months to 1 year of administrative, medical billing, pharmacy billing, or healthcare reimbursement experience preferred.
  

Preferred Qualifications 

• Knowledge of CMS-1500 claim forms, insurance terminology, and reimbursement processes preferred.
• Experience in specialty pharmacy, home infusion, medical billing, or copay assistance programs strongly preferred.
  

Physical Requirements

The physical requirements for this role includes constant sedentary work that primarily involves sitting/standing; ability to hear, see and speak; type and write, repeating motions that may include the wrists, hands and/or fingers.  Must be physically able to operate a computer and other office productivity machinery (i.e., a calculator, copy machine, printer); constantly communicate with colleagues and clients including via telephone and email. Must be able to lift up to 15 pounds at times. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EEO Statement 

The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.