Remote Clinical Pharmacist - ATI & Claims Specialist

Clarest Health; Troy (OH); Hybrid; USD 110,000 - 115,000; Full time

Benefits offered by this job

Medical, Dental, Vision insurance

Paid Time Off

Telemedicine access

401k with company match

Closed‑door Pharmacy—no face‑to‑face

Referral bonuses

Life Insurance

Growth opportunities

Job summary

Clarest Health’s Remedi SeniorCare division seeks a Clinical Service Center Pharmacist in Troy, OH. You will oversee clinical claim reject activity, recommend formulary alternatives, and review prior authorization documentation.

You’ll guide CSC Technicians and collaborate with LTC departments to achieve daily goals while adhering to state and federal regulations. The role requires a PharmD, Ohio licensure progress, and strong regulatory knowledge, with a mix of remote and onsite

Qualifications

• PharmD required.
• Must be eligible for pharmacist licensure and actively working toward licensure in Ohio.
• License must be in good standing.

Responsibilities

• Oversee clinical claim reject activity.
• Make clinically comparable formulary alternative recommendations.
• Review and approve clinical documentation for prior authorization submissions.
• Instruct CSC Technicians on actions to resolve rejected claims with insurers.
• Collaborate with LTC departments to meet daily volume, quality, and service goals.
• Communicate with customers, insurers, and internal staff to resolve rejected claims.
• Maintain organized CSC documentation related to ATI or claims management.
• Demonstrate superior customer service with internal and external customers.
• Support department goals with Director and Technicians; contribute to initiatives.

Skills

Attention to detail

Organizational skills

Clinical knowledge

Regulatory compliance

Problem solving

Time management

Technical systems

Continuous learning

Communication skills

Interpersonal skills

Education

Doctor of Pharmacy (PharmD)

Pharmacist licensure in Ohio

Job description

Clarest Health’s Remedi SeniorCare division seeks a Clinical Service Center Pharmacist in Troy, OH. You will oversee clinical claim reject activity, recommend formulary alternatives, and review prior authorization documentation.

You’ll guide CSC Technicians and collaborate with LTC departments to achieve daily goals while adhering to state and federal regulations. The role requires a PharmD, Ohio licensure progress, and strong regulatory knowledge, with a mix of remote and onsite