Pharmacy Reimbursement Specialist (Remote/Evening Shift)

Absolute Health Care; North Canton (OH); Hybrid; USD 35,000 - 52,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Paid time off

Holidays

Shift differential after 5pm

Job summary

Absolute Health Care in North Canton, OH is seeking a Pharmacy Adjudication / Reimbursement Specialist to join our Long Term Care Pharmacy team. You will verify patient demographics and insurance information, submit claims electronically, and manage prior authorizations in a fast-paced environment.

This is a full-time in-office role with benefit package, including medical and dental insurance, earned Paid Time Off and Holidays.

Qualifications

• Detail-oriented with strong organizational skills.
• Excellent written and verbal communication abilities.
• Ability to multitask and manage competing priorities.
• Pharmacy Technician Certification within 1 year of hire.
• State registration required.

Responsibilities

• Verify patient demographics and insurance information for accuracy.
• Submit 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

Organizational skills

Verbal communication

Written communication

Multitasking

Independent worker

Education

Pharmacy Technician Certification

State registration

Tools

Microsoft Word

Microsoft Excel

Job description

Absolute Health Care in North Canton, OH is seeking a Pharmacy Adjudication / Reimbursement Specialist to join our Long Term Care Pharmacy team. You will verify patient demographics and insurance information, submit claims electronically, and manage prior authorizations in a fast-paced environment.

This is a full-time in-office role with benefit package, including medical and dental insurance, earned Paid Time Off and Holidays.