Claims Specialist

Job Summary

A company is looking for a Claims Specialist to manage and resolve pharmacy claims efficiently.

Key Responsibilities

• Manage and identify rejected pharmacy claims to ensure maximum payer reimbursement
• Research and resolve rejected claims by collaborating with national Medicare D plans and insurance companies
• Monitor revenue associated with payer setup, billing, and reversal processes

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
• Pharmacy Technician experience is preferred but not required
• Ability to work in a fast-paced environment and basic math aptitude required
• Knowledge of insurance industry trends is desired