Claims Specialist Near Rochester NY (MUST have Pharmacy Technician experience)

Join our Long-Term Care Mail Order Pharmacy team as a Claims Specialist and play a key role in ensuring accurate and timely reimbursement for pharmacy claims. This is a fantastic opportunity for detail-oriented professionals with a background in pharmacy and customer service.

Key Responsibilities:

• Investigate and resolve rejected pharmacy claims to secure maximum payer reimbursement.
• Analyze claims issues and collaborate with Medicare D plans, Medicaid plans, and third-party insurers to resolve billing discrepancies.
• Perform edits or reversals to facilitate claim approvals and reduce financial risks.
• Identify, document, and address trends in billing and reimbursement issues.
• Assist with payer setup and ensure accurate billing and rebilling processes.

Qualifications:

• Previous pharmacy technician experience is required.
• Strong customer service skills.
• Ability to retain and apply knowledge in a fast-paced environment.
• Proficient in Microsoft Office Suite and basic math skills.
• Preferred: Knowledge of insurance industry trends and pharmacy technician licensure.

Compensation: $18-20 / hour depending on experience
Shift: Monday - Friday 1 PM - 9 PM

Why RPh on the Go?
RPh on the Go connects skilled professionals with career opportunities tailored to their expertise. Enjoy a supportive environment, competitive pay, and opportunities for growth.

Apply Today!
Contact [email protected] to submit your application.