Pharmacy Specialist

Our Company:

PharMerica

Overview:

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.

Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.

This is a REMOTE position and can work from anywhere in the continental United States.

We offer:

DailyPay

Flexible schedules

Competitive pay

Shift differential

Health, dental, vision and life insurance benefits

Company paid STD and LTD

Tuition Assistance

Employee Discount Program

401k

Paid-time off

Tuition reimbursement

Non-retail/Closed-door environment

Our 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.

This is a hybrid or remote opportunity.

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
Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes
Works as a team to identify, document, communicate and resolve payer/billing trends and issues
Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans
Prepares and maintains reports and records for processing
Performs other tasks as assigned
Qualifications:

Education/Learning Experience:

Required: High School Diploma or GED
Desired: Associate's or Bachelor's Degree

Work Experience:

Required: Customer Service
Desired: Up to one year of related experience. Pharmacy Technician experience

Skills/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 Suite
Desired: Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters

Licenses/Certifications:

Desired: Pharmacy technician, but not required
About 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 . 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.