Claims Specialist

Job Summary

A company is looking for a Claims Specialist.

Key Responsibilities

• Manage and resolve rejected pharmacy claims to ensure timely billing and maximum reimbursement
• Research and analyze claims issues, collaborating with Medicare D plans, third-party insurers, and Medicaid
• Monitor revenue risks and assist in documenting and resolving billing trends and issues

Required Qualifications

• High School Diploma or GED required; Associate's or Bachelor's Degree desired
• Customer service experience required; up to one year of related experience preferred
• Basic math aptitude and proficiency in Microsoft Office Suite required
• Pharmacy technician experience is preferred but not required
• Knowledge of insurance industry trends is desired