Claims Specialist

Job Summary

A company is looking for a Claims Specialist.

Key Responsibilities

• Manage and resolve rejected pharmacy claims to ensure maximum reimbursement and timely billing
• Research and analyze rejected claims by collaborating with Medicare D plans, insurance companies, and Medicaid plans
• Monitor revenue associated with payer setup, billing, and reversal processes while preparing and maintaining processing reports

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
• Ability to retain information and work in a fast-paced environment
• Basic math aptitude and proficiency in Microsoft Office Suite required
• Pharmacy technician certification desired but not required