BrightSpring Health Services CLAIMS SPECIALIST in VANCOUVER, Washington
Join our PharMerica team! PharMerica is aclosed-door pharmacywhere you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh growth mode, which meansadvancement opportunitiesfor individuals who are looking for career progression!
We are seeking individuals who have experience in Pharmacy who are ready to make a change. This is an excellent opportunity for Pharmacy Technicians to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.
This is a remote position. Applicants can reside any where within the continental USA.
Schedule: Monday - Friday 12:30-9:00pm Pacific Time
Health, dental, vision and life insurance benefits
Company paid STD and LTD
Employee Discount Program
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!
• Training inclusive auditing for accuracy of claim processing and working with team on training documents• Third Party Claims processing and payer subject matter expert• Provide support to 3rd Party Claims Specialist I answering operational questions• Support supervisory team by monitoring 3rd party at risk revenue• Support supervisory team with managing work queue• Review/resolve elevated issues• Complete quality assessment review of staff transactions• Work as a team to identify, document, communicate and resolve payer/billing trends and issues• Provide feedback to supervisor on staff performance• Prepares and maintains reports and records for processing.• Back up support for all operational functions of team including but not limited to research, analyze and appropriately resolve 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.• Review and code revenue adjustments and/or write offs for management review and approval• Establish payer relationships to support operations• Performs other tasks as assigned.• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Learning Experience• Required: High School Diploma or GED• Desired: Associate’s or Bachelor’s Degree
Work Experience• Required: Customer Service. Up to 2 years of related experience• Desired: Pharmacy Technician experience. Leadership
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. Framework LTC or similar platform.
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 www.pharmerica.com. Follow us on Facebook (https://www.facebook.com/PharMericaCorp/) , Twitter (https://twitter.com/PharMericaCorp/) , andLinkedIn (https://www.linkedin.com/company/pharmerica/) .
USD $22.00 / Hour
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ALERT: We are aware of a scam whereby imposters are posing as employees from our company. Beware of anyone requesting financial or personal information. We take pride in creating a best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, driver’s license, bank information, or payment for work equipment, etc.) from you via text or email. If you are suspicious of a job posting or job-related email mentioning our company, please contact us at TalentAcquisition@brightspringhealth.com .
Click here (https://www.brightspringhealth.com/careers/frequently-asked-questions/) for additional FAQ information.
Line of Business PharMerica
Position Type Full-Time
Pay Min USD $22.00/Hr.
Pay Max USD $22.00/Hr.