Our Company PharMerica 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! 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! We are seeking dynamicAdjudicators-Point of Salewith 3rdparty claims experience. Pharmacy Technicians seeking an alternative career move from the retail environment are desired This is a remote position. Applicants can live anywhere within the continental USA. Schedule: Monday-Friday, 8:30am to 5:00pm Central time Zone We offer: DailyPay Flexible schedules Competitive pay Shift differential Health, dental, vision and life insurance benefits Company paid STD and LTD Employee Discount Program 401k Paid-time off Tuition reimbursement Non-retail/Closed-door environment If your passion is service excellence and top-quality care come join our team and apply today! *Position will be posted for a minimum of 7 business days Responsibilities TheClaims 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 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/) . Salary Range USD $21.00 - $23.00 / Hour 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. Job LocationsUS-CO-LONGMONT ID 2024-142191 Line of Business PharMerica Position Type Full-Time Pay Min USD $21.00/Hr. Pay Max USD $23.00/Hr.