Pharmacist

Integrated Resources, Inc ( IRI ); United States; On-site; USD 73,012 - 75,768; Full time

Job summary

Integrated Resources, Inc (IRI) is seeking a licensed Pharmacist with Medicare Part B expertise to support prescription processing, claims adjudication, and reimbursement activities in a fast-paced setting. The role demands a strong understanding of CMS regulations and Part B billing within pharmacy workflows to ensure accurate, compliant dispensing.

You will review documentation, resolve denials, counsel patients on Medicare Part B benefits, and stay current with evolving rules.

Qualifications

• Requires PharmD or Bachelor’s in Pharmacy from an accredited institution.
• Strong understanding of CMS regulations and Medicare Part B billing.
• Experience with pharmacy claims adjudication and prior authorization processes.
• Excellent communication, analytical, and customer service skills.
• Ability to work independently in a fast-paced environment.

Responsibilities

• Review, verify, and dispense prescriptions per regulations.
• Process and adjudicate Medicare Part B pharmacy claims accurately.
• Ensure CMS guidelines and Part B billing compliance.
• Review physician documentation for medical necessity and coverage.
• Resolve claim denials, rejections, and reimbursement issues.
• Collaborate with physicians, patients, and insurers for required docs.
• Counsel patients on medication therapy and Medicare Part B benefits.
• Maintain HIPAA-compliant pharmacy records and company policies.
• Support QA initiatives and process improvements.
• Stay current with Medicare Part B regulations and policies.

Skills

CMS regulations

Medicare Part B billing

pharmacy claims adjudication

communication skills

independent work

Education

PharmD or B.Pharmacy

Tools

Pharmacy management systems

Electronic prescription platforms

Job description

Pay Rate: $53–$55/hour on W2 (Negotiable)

Position Overview

We are seeking a licensed Pharmacist with experience in Medicare Part B pharmacy operations to support prescription processing, claims adjudication, and reimbursement activities. The ideal candidate will have a strong understanding of Medicare Part B billing requirements, CMS regulations, and pharmacy workflows while ensuring accurate, compliant, and timely prescription dispensing.

Key Responsibilities

• Review, verify, and dispense prescriptions in accordance with state and federal pharmacy regulations.
• Process and adjudicate Medicare Part B pharmacy claims accurately and efficiently.
• Ensure compliance with CMS guidelines and Medicare Part B billing requirements.
• Review physician documentation to verify medical necessity and coverage eligibility.
• Resolve claim denials, rejections, and reimbursement issues.
• Collaborate with physicians, patients, and insurance providers to obtain required documentation.
• Counsel patients on medication therapy, Medicare Part B benefits, and proper medication use.
• Maintain accurate pharmacy records while ensuring compliance with HIPAA and company policies.
• Support quality assurance initiatives and process improvements.
• Stay current with Medicare Part B regulations, reimbursement policies, and pharmacy best practices.

Required Qualifications

• PharmD or Bachelor's Degree in Pharmacy from an accredited institution.
• Strong understanding of CMS regulations, Medicare Part B billing, and reimbursement.
• Experience with pharmacy claims adjudication and prior authorization processes.
• Excellent communication, analytical, and customer service skills.
• Ability to work independently in a fast-paced environment.

Preferred Qualifications

• Experience in retail, specialty, mail-order, infusion, or ambulatory pharmacy settings.
• Knowledge of DMEPOS billing and Medicare documentation requirements.
• Experience using pharmacy management systems and electronic prescription platforms

Work Schedule

• 8-hour shifts on a rotating schedule.
• Candidates must be flexible to work assigned shifts, including weekends.
• Attendance is mandatory during the onboarding and training period.
• First 8 weeks: Monday–Friday, 9:00 AM – 5:30 PM EST.
• No planned time off should be scheduled during the initial training period.