Pharmacy Technician Claims Specialist - Evenings (1pm-9pm) - West Henrietta, NY

Claims Specialist (Evening Shift) - 8-Week Contract with Potential for Direct Hire

Shift: Monday to Friday, 1:00 PM - 9:00 PM
Environment: Long-Term Care (LTC) Mail Order Pharmacy

Position Overview:
We are seeking a Claims Specialist to manage and resolve rejected pharmacy claims within a long-term care mail order pharmacy environment. This 8-week position comes with the potential for direct hire based on performance. You ll be responsible for ensuring maximum payer reimbursement by addressing rejected claims, working with Medicare D plans, third-party insurance companies, and state Medicaid plans, and meeting critical billing deadlines.

Key Responsibilities:

• Manage a portfolio of rejected pharmacy claims to secure maximum reimbursement and minimize financial risks.
• Research, analyze, and resolve rejected claims by collaborating with national Medicare D plans, third-party insurers, and Medicaid programs.
• Perform appropriate edits and reversals to ensure claims approval and maximize payer reimbursement.
• Monitor and address at-risk revenue through payer setup, billing, rebilling, and reversal processes.
• Collaborate with the team to identify, document, communicate, and resolve billing trends and payer issues.
• Review billing data to convert claims where necessary.

Required Skills and Experience:

• Pharmacy Technician experience is essential.
• Strong customer service background.
• Ability to retain large amounts of information and apply it effectively in related situations.
• Thrive in a fast-paced environment.
• Basic math skills and proficiency in Microsoft Office Suite.
• Ability to adapt to the evolving landscape of pharmacy claims.

Desired Skills:

• Knowledge of insurance industry trends, issues, regulations, and key players.
• Pharmacy Technician License (preferred, not required).

If you are a detail-oriented and efficient professional with a background in pharmacy and claims management, we encourage you to apply for this rewarding opportunity.

Apply Today!
For more details or to submit your application, please reach out to Megan at [email protected] or call/text (813)-774-5350