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Claims Specialist


Pay$19.00 - $20.00 / hour
LocationLouisville/Kentucky
Employment typeFull-Time

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  • Job Description

      Req#: 164569
      Employer Industry: Pharmacy Services

      Why consider this job opportunity:
      - Salary up to $20.00 per hour
      - DailyPay available for immediate access to earned wages
      - Flexible schedules with the option to work four 10-hour days
      - Comprehensive benefits including health, dental, vision, and life insurance
      - Opportunities for career advancement within a rapidly growing organization
      - 100% remote position, allowing for work from anywhere in the Continental USA

      What to Expect (Job Responsibilities):
      - Manage and resolve rejected pharmacy claims to ensure timely billing and maximum reimbursement
      - Research and analyze rejected claims while collaborating with national Medicare D plans and state Medicaid plans
      - Perform edits and reversals to secure claim approvals and maximize reimbursements
      - Monitor at-risk revenue related to payer setup, billing, and reversal processes
      - Document and communicate payer/billing trends and issues as part of a collaborative team

      What is Required (Qualifications):
      - High School Diploma or GED required
      - Experience in customer service is mandatory
      - Ability to work in the Eastern Time Zone
      - Basic math aptitude and familiarity with Microsoft Office Suite
      - Ability to retain and apply a large amount of information in a fast-paced environment

      How to Stand Out (Preferred Qualifications):
      - Up to one year of experience in a related field
      - Pharmacy Technician experience or knowledge of pharmaceuticals is preferred
      - Associate's or Bachelor's Degree is desired

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