340B Claims Specialist – Reimbursement & Pharmacy Support

BrightSpring Health Services; Blanco (TX); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

DailyPay

Flexible Schedules

Competitive Pay with Shift Differenti

Health, Dental, Vision, and Life Ins

Company-Paid Disability Insurance

Tuition Assistance & Reimbursement

Employee Discount Program

401k Plan

Paid Time Off

Non-Retail, Closed-Door Environment

Job summary

PharMerica, part of BrightSpring Health Services, seeks a 340B Claims Specialist to optimize payer reimbursement through thorough claims processing. You will resolve rejected claims, work with national Medicare D plans and Medicaid, and ensure timely billing with accuracy.

Experience in pharmacy claims, strong attention to detail, and proficiency with Microsoft Office are valued. This role supports hospitals, long-term care facilities and other care centers nationwide.

Qualifications

• High school diploma or GED required; associate or bachelor's preferred.
• Customer service experience required; pharmacy knowledge a plus.
• Ability to work in a fast-paced environment with attention to detail.
• Proficiency in Microsoft Office and basic math understood.

Responsibilities

• Manage and identify a portfolio of rejected pharmacy claims to maximize payer reimbursement and timely billing.
• Research, analyze and resolve rejected claims with Medicare D plans, third party insurers, and Medicaid.
• Ensure claims approvals by performing edits/reversals to maximize reimbursement.
• Monitor revenue at risk related to payer setup, billing, rebilling and reversals.
• Collaborate with team to identify payer/billing trends and resolve issues.
• Convert billing exception reports to ensure accurate financial plans are billed.
• Prepare and maintain reports for processing.
• Perform other assigned tasks.

Skills

Customer Service

Fast-paced environment

Basic math

Microsoft Office

Education

High School Diploma or GED

Associate's or Bachelor's Degree

Job description

PharMerica, part of BrightSpring Health Services, seeks a 340B Claims Specialist to optimize payer reimbursement through thorough claims processing. You will resolve rejected claims, work with national Medicare D plans and Medicaid, and ensure timely billing with accuracy.

Experience in pharmacy claims, strong attention to detail, and proficiency with Microsoft Office are valued. This role supports hospitals, long-term care facilities and other care centers nationwide.