Pharmacy Claims Processor / Remote
PharMerica (BrightSpring Health) · Remote (Louisville, KY)
- Manage and resolve a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risk.
- Research, analyze, and resolve rejected claims by working with national Medicare D plans, third-party insurance companies, and state Medicaid plans to maximize payer reimbursement while meeting critical deadlines.
- Ensure approval of claims by performing appropriate edits and/or reversals; monitor and resolve at-risk revenue associated with payer setup, billing, rebilling, and reversal processes.
- Work as a team to identify, document, communicate, and resolve payer/billing trends; review billing exception reports and prepare reports/records.
- Requires HS diploma or GED; customer service experience required; up to one year related experience and pharmacy technician experience desired; basic math and Microsoft Office Suite.
- Shift: Nights and weekends; 100% remote; competitive pay with shift differentials.
- Benefits: DailyPay, flexible schedules, health/dental/vision/life, company-paid disability, tuition assistance, employee discounts, 401k, PTO, non-retail closed-door environment.
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