Pharmacy Rejections Specialist — Growth & Impact

Specialty Rx, INC.; Morton Grove (IL); Vor Ort; USD 42.000 - 64.000; Vollzeit

Benefits dieser Stelle

Health, dental, and vision insurance

401(k) with company match

Paid time off and paid holidays

Paid training and development

Group life insurance and short-termdis

Zusammenfassung

SpecialtyRx, Inc. in Illinois is hiring a Third-Party Rejections Specialist to manage research, resolution, and processing of pharmacy insurance rejections. This role emphasizes hands-on third-party rejection experience and strong communication with insurers.

You will join a fast-growing Long-Term Care pharmacy serving facilities and communities. Candidates must reside in Illinois and be able to work on multiple shifts, including evenings or weekends.

Qualifikationen

• Direct, hands-on experience working with third-party pharmacy insurance rejections is required.
• Experience must be in actual third-party rejection processing/resolution.
• Strong computer skills and ability to learn and navigate multiple systems.
• Excellent attention to detail and problem-solving skills.
• Professional and courteous telephone communication skills.
• Ability to work independently and as part of a team.
• Ability to multitask and prioritize work in a fast-paced environment.
• Strong organizational skills and follow-through.

Aufgaben

• 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.

Kenntnisse

Third-party rejection experience

Pharmacy billing

Attention to detail

Communication skills

Independent & team work

Ausbildung

High school diploma or equivalent

Jobbeschreibung

SpecialtyRx, Inc. in Illinois is hiring a Third-Party Rejections Specialist to manage research, resolution, and processing of pharmacy insurance rejections. This role emphasizes hands-on third-party rejection experience and strong communication with insurers.

You will join a fast-growing Long-Term Care pharmacy serving facilities and communities. Candidates must reside in Illinois and be able to work on multiple shifts, including evenings or weekends.