Pharmacy Specialist

Reimbursement Specialist

Rx relief is seeking multiple dedicated Reimbursement Specialists to support our expanding healthcare operations near Fort Lauderdale, FL. This position is ideal for revenue cycle professionals who excel at navigating insurance workflows, resolving complex claim disputes, and securing accurate reimbursement.

Core Responsibilities

• Manage full-cycle billing and collections for pharmacy claims, specializing in Workers' Compensation and Personal Injury cases.
• Analyze aging reports to identify delinquent or underpaid accounts and initiate timely payment recovery.
• Investigate claim denials and payment adjustments to determine root causes and secure proper funding.
• Compile necessary clinical files and medical documentation to construct effective formal appeals.
• Audit claims for errors, correcting patient demographics, CPT codes, and ICD-10 diagnosis codes prior to resubmission.
• Liaise with insurance carriers, legal representatives, and clinical personnel to resolve open accounts.
• Maintain organized account records and assist with specialized billing projects as needed.

Qualifications & Requirements

• Minimum of 2 years of hands-on medical billing and collections experience (Workers' Comp background strongly preferred).
• Working knowledge of insurance claims processing, EOB evaluation, CPT/ICD-10 coding, and denial resolution.
• Proficiency with Microsoft Excel and medical billing software.
• Strong analytical, investigative, and problem-solving skills with high attention to detail.
• Excellent written and verbal communication skills with professional phone etiquette.
• Ability to work independently while contributing effectively to a fast-paced team environment.

Compensation / Pay Rate (Up to): $20.00 Per Hour