LTC Pharmacy Claims Specialist / Remote

Responsibilities: Manage and resolve rejected pharmacy claims to ensure maximum payer reimbursement and timely billing. Research and analyze claims by coordinating with Medicare D, third-party insurance, and state Medicaid plans.

Requirements: Requires a High School Diploma or GED and experience in customer service or pharmacy claims adjudication. A Pharmacy Technician certification or degree is desired but not required.

Key skills: Pharmacy Claims Management, Claims Adjudication, Customer Service, Microsoft Office Suite, Billing and Reimbursement, Insurance Processing, Data Analysis, Basic Math

Keywords: Pharmacy Claims, Adjudication, Medicare D, Medicaid, Payer Reimbursement, Billing Exception Reports, LTC Pharmacy, Pharmacy Technician, Healthcare Billing, Insurance Industry, Closed-Door Pharmacy, Financial Risk Management