Pharmacy Reimbursement Specialist - Detail-Driven & Impactful

Absolute Health Services; North Canton (OH); On-site; USD 38,000 - 59,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Paid time off

Holidays

Shift differential after 5pm

Job summary

Absolute Health Services in North Canton, OH is seeking a Pharmacy Adjudication / Reimbursement Specialist to ensure accurate billing for prescriptions. You will verify patient demographics and insurance details, submit claims electronically, and handle prior authorizations while maintaining payer compliance.

The role offers a comprehensive benefit package including medical and dental insurance, paid time off, holidays, and a shift differential after 5pm.

Qualifications

• State registration required.
• Pharmacy Technician Certification required within 1 year of hire.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication skills.
• Ability to multitask and manage competing priorities.
• Self-motivated with the ability to work both independently and as part of a team.
• Basic proficiency in Microsoft Word and Excel.

Responsibilities

• Verify patient demographics and insurance information for accuracy.
• Submission of claims to Insurance Companies electronically.
• Perform insurance verifications and eligibility checks.
• Handle inbound and outbound calls with facilities, guarantors, and insurance companies.
• Initiate and follow up on prior authorizations.
• Review and respond to insurance audit requests.
• Investigate and resolve insurance and Medicaid rejections.
• Maintain accurate documentation of all billing activities.
• Perform other duties as assigned.

Skills

Attention to detail

Communication skills

Multitasking

Teamwork

MS Word & Excel

Education

State registration required

Pharmacy Technician Certification within 1 year of hire

Tools

Microsoft Word

Excel

Job description

Absolute Health Services in North Canton, OH is seeking a Pharmacy Adjudication / Reimbursement Specialist to ensure accurate billing for prescriptions. You will verify patient demographics and insurance details, submit claims electronically, and handle prior authorizations while maintaining payer compliance.

The role offers a comprehensive benefit package including medical and dental insurance, paid time off, holidays, and a shift differential after 5pm.