Remote Claims Team Lead: Denials & Training Expert

Pharmerica; Louisville (KY); Remote; USD 65,000 - 82,000; Full time

Benefits offered by this job

Medical, Dental, Vision insurance

Health Savings & Flexible Spending

Tuition discounts & reimbursement

401(k)

Paid Time Off

Shift Differential

DailyPay

Pet Insurance

Wellness programs

Job summary

PharMerica is seeking a 3rd Party Claims Specialist Team Lead to oversee denial research, billing accuracy and payer interactions from a remote Louisville-area setting. The role trains staff, mentors teammates, and ensures compliant, timely claims processing across Medicare, Medicaid and commercial billing.

Responsibilities include staff coaching, performance feedback, and process improvement to reduce variances and write-offs, with a focus on quality outcomes and regulatory compliance.

Qualifications

• High School graduate or equivalent; associates/technical degree preferred.
• 3+ years insurance billing experience.
• Specialized understanding of Medicare Part D, Medicaid, and Commercial billing.
• Knowledge of revenue cycle functions in pharmacy or similar setting.

Responsibilities

• Trains new employees and provides materials for onboarding.
• Mentors staff and promotes a positive work environment.
• Provides feedback for performance reviews and coaching.
• Identifies performance issues and coordinates retraining.
• Assists management with workload balancing and assignments.
• Reviews variances and write-offs for accuracy before supervisor approval.
• Performs monthly quality assessments and reports training needs.
• Prepares reports and runs miscellaneous processing reports.
• Keeps up with third-party billing requirements and payer rules.
• Coordinates with payers and staff to ensure accurate claims processing.

Skills

Analytical skills

MS Office (Excel, Word)

Time management

Communication

Mentoring / coaching

Attention to detail

Team leadership

Education

High School graduate

Associates degree

4 year college or technical degree

Tools

AS400

Frameworks

QS1

Other health care billing systems

Job description

PharMerica is seeking a 3rd Party Claims Specialist Team Lead to oversee denial research, billing accuracy and payer interactions from a remote Louisville-area setting. The role trains staff, mentors teammates, and ensures compliant, timely claims processing across Medicare, Medicaid and commercial billing.

Responsibilities include staff coaching, performance feedback, and process improvement to reduce variances and write-offs, with a focus on quality outcomes and regulatory compliance.