claims specialist - Honolulu, United States - BrightSpring Health Services

BrightSpring Health Services Honolulu, United States

2 weeks ago

Description

CLAIMS SPECIALIST - 3RD PARTY

Job Locations

US-HI-HONOLULU

ID

Line of Business

PharMerica

Position Type

Full-Time

Pay Min

USD $19.00/Hr.

Pay Max

USD $19.00/Hr.

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

Schedule:

Monday-Saturday; with a day off during the week--please note this role is ON-SITE in Honolulu, HI

Pay Rate:

$22/HR

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

Responsibilities

The Claims Specialist - 3rd Party:

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 isone of the nation'slargest 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 Follow us onFacebook,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 / Hour

claims Specialist

2 weeks ago

ResCare Honolulu, United States

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 hi ...
claims specialist

2 weeks ago

BrightSpring Health Services Honolulu, United States

CLAIMS SPECIALIST - 3RD PARTY · Job Locations · US-HI-HONOLULU · ID · Line of Business · PharMerica · Position Type · Full-Time · Pay Min · USD $19.00/Hr. · Pay Max · USD $19.00/Hr. · Our Company · PharMerica · Overview · Join our PharMerica team · PharMerica is a ...
claims specialist

2 weeks ago

PharMerica Honolulu, United States

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 organizat ...
claims Specialist

2 weeks ago

ResCare Honolulu, United States

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 ...
Claims Operation Specialist

3 weeks ago

Hawaii Medical Service Association Honolulu, United States

Job Summary · Pay Range: $47,500 - $88,000 · Note: Individuals typically begin between the minimum to middle of the pay range · The Claims Operation Specialist tracks, analyzes, and resolves claims and claims related system issues while collaborating with our vendor to streamli ...
Claim Specialist WC

2 days ago

HEMIC Honolulu, United States

Job Description · Job DescriptionJoin us at HEMIC · Voted one of Hawai`i Business' Best Places to Work for 5 Years in a Row · As a HEMIC employee, you will get: · People Who Care · Voted one of Hawai`i Business' Best Places to Work, and Pacific Business News' Best Workplaces, our ...
Claim Specialist WC

2 weeks ago

HEMIC Honolulu, United States

Join us at HEMIC · Voted one of Hawai`i Business' Best Places to Work for 5 Years in a Row · As a HEMIC employee, you will get: People Who Care · Voted one of Hawai`i Business' Best Places to Work, and Pacific Business News' Best Workplaces, our business is founded on caring fo ...
Claims Operation Specialist

2 weeks ago

Hawaii Medical Service Association Honolulu, United States

Note: · Individuals typically begin between the minimum to middle of the pay range · The Claims Operation Specialist tracks, analyzes, and resolves claims and claims related system issues while collaborating with our vendor to streamline operational processes. In this role, the ...
Medical Claim Specialist

2 days ago

HEMIC Honolulu, United States

Job Description · Job DescriptionJoin us at HEMIC · Voted one of Hawai`i Business' Best Places to Work for 6 Years in a Row · As a HEMIC employee, you will get: · People Who Care · Voted one of Hawai`i Business' Best Places to Work, and Pacific Business News' Best Workplaces, our ...
LTD Claims Specialist

3 weeks ago

Lincoln Financial Group Honolulu, United States

Location field must contain 'city, state' or a zip code to perform a radius search (e.g., · Denver, CO · or · City and state must be separated by a comma followed by a space (e.g., · Houston, TX ) · Alternate Locations: · Charlotte, NC (North Carolina); Dover, NH (New Hampsh ...
Surety Claims Specialist

3 days ago

Sedgwick Honolulu, United States

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. Its an opportunit ...
Claim Specialist WC

2 weeks ago

HEMIC Honolulu, United States

Job Description · Job Description · Join us at HEMIC · Voted one of Hawai`i Business' Best Places to Work for 5 Years in a Row · As a HEMIC employee, you will get: · People Who Care · Voted one of Hawai`i Business' Best Places to Work, and Pacific Business News' Best Workplac ...
Claims Operation Specialist

2 weeks ago

HMSA Honolulu, United States

Collect, analyze, and utilize data and feedback related to Claims to identify opportunities to improve the relationship between the business and the other entity. This will include direct communication and participation with the Vendor Management Office (VMO) and Transformation M ...
Claims Operation Specialist

10 hours ago

HMSA Honolulu, United States

Collect, analyze, and utilize data and feedback related to Claims to identify opportunities to improve the relationship between the business and the other entity. This will include direct communication and participation with the Vendor Management Office (VMO) and Transformation M ...
Claims Operation Specialist

3 weeks ago

Hawaii Medical Service Association Honolulu, United States

Job SummaryPay Range: $47,500 - $88,000Note: Individuals typically begin between the minimum to middle of the pay rangeThe Claims Operation Specialist tracks, analyzes, and resolves claims and claims related system issues while collaborating with our vendor to streamline operatio ...
Life Claims Specialist

3 weeks ago

Lincoln Financial Group Honolulu, United States

Location field must contain 'city, state' or a zip code to perform a radius search (e.g., · Denver, CO · or · City and state must be separated by a comma followed by a space (e.g., · Houston, TX ) · Alternate Locations: · Work from Home · Work Arrangement: · Remote : Work at ...
Specialist, Default FHA MI Claims, II

2 weeks ago

Carrington Honolulu, United States

Come join our amazing team and work remote from home · The Default FHA Claims Specialist II will work under moderate supervision, be responsible for preparing, filing, and following up on FHA claims timely and accurately according to insurer/investor guidelines. Performs all duti ...
Integrated Absence Claims Specialist

4 weeks ago

Lincoln Financial Group Honolulu, United States

Lincoln Financial Group · Integrated Absence Claims Specialist · Honolulu , · Hawaii · Apply Now · Alternate Locations: · Work from Home; Boise, ID (Idaho); Omaha, NE (Nebraska); Phoenix, AZ (Arizona); Sacramento, CA (California); San Diego, CA (California); San Francisco, ...
Entry-Level Claims Specialist

2 weeks ago

ALTRES Staffing Honolulu, United States Full time

Entry-Level Claims Specialist (Workers' Comp Work for a local insurance company, voted one of Hawaii's Best Places to Work · As the Workers' Comp Claims Specialist, you will manage workers' compensation claims for medical only, lost time, and disfigurement. A current Hawaii worke ...
Short Term Disability Claims Specialist

4 weeks ago

Lincoln Financial Group Honolulu, United States

Location field must contain 'city, state' or a zip code to perform a radius search (e.g., · Denver, CO · or · City and state must be separated by a comma followed by a space (e.g., · Houston, TX ) · Lincoln Financial Group · Short Term Disability Claims Specialist · in · H ...