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claims specialist - Honolulu, United States - PharMerica
Description
Our CompanyPharMerica
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 weekplease note this role is
ON-SITE in Honolulu, HI
Pay Rate:
$19/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 todayResponsibilities
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 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 visit . Follow us on Facebook , Twitter , andLinkedIn .
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.
Salary Range
USD $19.00 / Hour
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