Jobs
>
Hilo

    adjudicator, point of sale - Hilo, United States - BrightSpring Health Services

    BrightSpring Health Services
    BrightSpring Health Services Hilo, United States

    2 weeks ago

    BrightSpring Health Services background
    Description


    ADJUDICATOR, POINT OF SALE



    Job Locations

    US-HI-HONOLULU | US-HI-PEARL CITY | US-HI-HILO

    ID



    Line of Business

    PharMerica

    Position Type

    Full-Time

    Pay Min

    USD $19.00/Hr.

    Pay Max

    USD $25.00/Hr.



    Our Company



    PharMerica



    Overview



    Our Point of Sale Adjudicators are crucial to our 3rd Part Claims activities and our business. This is an excellent opportunity to move from a retail pharmacy 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.

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

    Shift Hours are for our Hawaii West Coast Team: Shift Hours: 3pm-11:30pm (EST) Mon-Sat

    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

    Remote; can work from anywhere in continental USA. Prefers: Arlington, Longmont, and Taunton areas but open to any

    Schedule: Monday-Friday 9am - 5:30pm CST

    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:

      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 Follow us onFacebook,Twitter, and LinkedIn.



    Salary Range



    USD $ $25.00 / Hour


  • BrightSpring Health Services Hilo, United States

    Our Company · PharMerica · Overview · Our Point of Sale Adjudicators are crucial to our 3rd Part Claims activities and our business. This is an excellent opportunity to move from a retail pharmacy to office environment for those who are willing to learn claims, billing and ins ...


  • KTA Super Stores Hilo, United States

    Job Details · Job Location · KTA Puainako Store 3 - Hilo, HI · Position Type · Part Time · Salary Range · $ $17.00 Hourly · Description · PRIMARY RESPONSIBILITY · The primary responsibility of a POS Clerk is to ensure customer satisfaction by maintaining the pricing accura ...

  • Travis Mathew

    Client Associate

    2 days ago


    Travis Mathew Hilo, United States Part time

    Founded in 2007, TravisMathew draws its' inspiration from all aspects of Southern California culture and lifestyle. Our focus on making premier men's apparel for work and play has cemented our foothold in the sportswear world. Over the past several years, TravisMathew has been le ...


  • Troon Golf Hilo, United States

    At the Princeville Makai Golf Club, our Golf Shop Attendants are the welcoming faces that greet customers and provide them with a superior buying and golf experience. We're searching for a qualified associate to add to our team, and to provide the excellent customer service and s ...


  • County of Hawaii (HI) Hilo, United States

    Duties Summary · Performs a variety of real property tax collection assignments, which require field contacts with delinquent taxpayers; and performs other related duties as required. · One (1) immediate, permanent, full-time vacancy with the Department of Finance - Real Property ...

  • Alaka'i Services Group Inc / Po'e Hana Group, Inc.

    Data Analyst

    6 days ago


    Alaka'i Services Group Inc / Po'e Hana Group, Inc. Hilo, United States

    Job Purpose · Data Analysis is responsible for overseeing our data systems and reporting frameworks, guaranteeing the integrity and precision of data. A data analyst collects and stores data on sales numbers, market research, logistics, linguistics, or other behaviors. They brin ...

  • Hawaii County, HI

    Purchasing Agent

    2 weeks ago


    Hawaii County, HI Hilo, United States

    Salary : $78, $111,036.00 Annually · Location : Future vacancies with immediate vacancy in Hilo, HI · Job Type: Permanent & Temporary Positions · Job Number: · Department: Finance · Division: Purchasing · Opening Date: 09/17/2023 · Closing Date: Continuous · Duties Summar ...

  • Troon Golf

    Makai Grill Attendant

    4 weeks ago


    Troon Golf Hilo, United States

    Princeville Makai Golf Club is excited to announce the exceptional career opportunity of Makai Grill Attendant.Qualified candidates will thrive in a hospitality environment and be highly focused on providing superior service for our guests.Please apply in person at 4080 Lei O Pap ...

  • Sonic Healthcare

    Billing Specialist

    2 weeks ago


    Sonic Healthcare Hilo, United States Full time

    Job Functions, Duties, Responsibilities and Position Qualifications: · Quality is in our DNA; is it in yours? · You are a superhero when it comes to customer service. You've got problem-solving instincts, a passion for patient care, and the drive to keep things running smoothly ...

  • Clinical Laboratories of Hawaii

    Billing Specialist

    2 weeks ago


    Clinical Laboratories of Hawaii Hilo, United States Full time

    Job Functions, Duties, Responsibilities and Position Qualifications: · Quality is in our DNA; is it in yours? · You are a superhero when it comes to customer service. Youve got problem-solving instincts, a passion for patient care, and the drive to keep things running smoothly. ...

  • County of Hawaii

    Purchasing Agent

    3 weeks ago


    County of Hawaii Hilo, United States

    Duties Summary · Plans and directs the centralized purchasing of materials, supplies, equipment, and services required by the County of Hawai`i; provides advice and assistance to operating departments on matters relating to procurement; develops and implements policies and standa ...