Remote Clinical Service Center Pharmacist — LTC Claims

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

Benefits offered by this job

Medical, Dental, Vision Insurance

Paid Time Off

401k with company match

Free telemedicine

Job summary

Clarest Health is seeking a Clinical Service Center Pharmacist for Remedi SeniorCare in Troy, OH. The role collaborates with leadership to review rejected claims, recommend clinically appropriate alternatives, and manage ATI processing to meet service goals.

Hybrid work arrangement after training, with occasional onsite requirements; must reside within commutable distance to the office. Ohio licensure eligibility and PharmD are required.

Qualifications

• PharmD required and eligible for pharmacist licensure in Ohio.
• Must maintain licensure in good standing.
• Strong regulatory and documentation skills.

Responsibilities

• Oversee clinical claim reject activity and determine appropriate alternatives.
• Review and approve clinical documentation for prior authorizations.
• Provide instructions to CSC Technicians for processing rejected claims.
• Collaborate with LTC departments to meet daily volume and quality goals.
• Maintain records of ATI or claims management and ensure proper documentation.

Skills

Attention to detail

Regulatory compliance

Problem solving

Time management

Communication

Education

PharmD

OH licensure eligibility

Job description

Clarest Health is seeking a Clinical Service Center Pharmacist for Remedi SeniorCare in Troy, OH. The role collaborates with leadership to review rejected claims, recommend clinically appropriate alternatives, and manage ATI processing to meet service goals.

Hybrid work arrangement after training, with occasional onsite requirements; must reside within commutable distance to the office. Ohio licensure eligibility and PharmD are required.