Pharmacy Billing: Third-Party Rejections Specialist

City of Lincoln; Elizabethtown (KY); Remote; USD 42,000 - 64,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Group life insurance and short-term

401(k) with company match

Paid time off and holidays

Job summary

SpecialtyRx, Inc. is seeking a Third-Party Rejections Specialist to join our billing team. This role focuses on hands-on third-party insurance rejection experience, researching, resolving, and processing rejections to ensure accurate patient billing.

Candidates must reside in Ohio, Virginia, or Kentucky. We offer competitive pay, health, dental, and vision coverage, paid time off, and opportunities for career growth.

Qualifications

• Direct, hands-on experience handling third-party pharmacy insurance rejections.
• Experience researching, resolving, and processing third-party rejections.
• Strong computer skills and ability to learn multiple systems.
• Excellent attention to detail and problem-solving.
• Professional and courteous telephone communication.
• Ability to work independently and as part of a team.
• Ability to multitask and prioritize in a fast-paced environment.

Responsibilities

• Perform duties and responsibilities assigned by the Billing Supervisor.
• Research and verify patient eligibility and insurance coverage with state and private insurance providers.
• Research, analyze, and resolve third-party insurance rejections in accordance with daily rejection reports.
• Maintain and update patient billing, insurance, and coverage information in the system.
• Submit and follow up on prior authorizations for state insurance programs.
• Communicate directly with insurance companies regarding rejections, overrides, eligibility issues, coverage changes, and claim updates.
• Investigate and resolve pending billing and insurance issues.
• Work with client facility staff and other applicable healthcare organizations and agencies, including PDP/Medicare, CMS, NJM, and NYM, when necessary.
• Maintain accurate documentation and ensure billing information is current and complete.
• Work independently while collaborating with the billing team to meet daily goals and deadlines.
• Handle multiple priorities in a fast-paced environment while maintaining accuracy and attention to detail.

Skills

Third-party rejection experience

Attention to detail

Communication skills

Multitasking

Independent / team player

Education

High school diploma or equivalent

Job description

SpecialtyRx, Inc. is seeking a Third-Party Rejections Specialist to join our billing team. This role focuses on hands-on third-party insurance rejection experience, researching, resolving, and processing rejections to ensure accurate patient billing.

Candidates must reside in Ohio, Virginia, or Kentucky. We offer competitive pay, health, dental, and vision coverage, paid time off, and opportunities for career growth.