Pharmacy Claims Representative 2
- Competitive Pay
- Comprehensive Benefits Package (Health, Dental, Vision, PTO, Sick Time, 401k w/match, etc.)
- Growth Opportunity and Career Advancement
- Agile and Adaptable team culture
- Innovative and revolutionary technology solutions
- A higher calling to provide quality patient care
- Review, analyze, and process pharmacy claims with accuracy, timeliness, and adherence to company and regulatory standards.
- Identify discrepancies, investigate claim issues, and determine appropriate resolutions.
- Communicate effectively with pharmacies, providers, and internal teams to clarify information and resolve errors.
- Support audits and quality reviews by maintaining detailed, accurate claim documentation.
- Identify trends and share insights that can improve claim accuracy and efficiency.
- Uphold confidentiality and compliance with HIPAA and corporate policy standards.
- 1–2 years of pharmacy claims or healthcare operations experience.
- Working knowledge of pharmacy billing procedures, insurance verification, and third-party payer systems.
- Strong analytical, organizational, and data-entry skills.
- Proficiency in claims processing platforms and Microsoft Office tools.
- Ability to communicate professionally with providers and team members.
- High attention to detail and a commitment to getting it right the first time.
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