Pharmacy Claims Processor - Remote / Telecommute

To support a growing organization, the full-time 340B Claims Specialist will manage and resolve pharmacy claims efficiently in a 100% remote environment, ensuring clients receive the necessary pharmaceutical support.

Key responsibilities

Manages a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing

Researches and resolves rejected claims by collaborating with Medicare D plans, third-party insurers, and state Medicaid plans

Monitors revenue associated with payer setup, billing, and reversal processes while documenting and communicating billing trends

Required qualifications

High School Diploma or GED required; Associate's or Bachelor's Degree preferred

Customer service experience required; up to one year of related experience preferred

Ability to retain and apply a large amount of information in a fast-paced environment

Basic math aptitude and proficiency in Microsoft Office Suite required

Knowledge of the insurance industry's trends and regulatory considerations is preferred