Remote Pharmacy Claims Specialist

StateServ; Mesa (AZ); Hybrid; USD 25,000 - 36,000; Full time

Job summary

StateServ is seeking a Pharmacy Claims Representative in Mesa, AZ to review, analyze, and process pharmacy claims in a remote call center environment. You will ensure accuracy, resolve discrepancies, and maintain compliance with HIPAA and company standards.

The role requires 1+ year in pharmacy claims billing or healthcare operations, with proficiency in claims processing platforms and Microsoft Office. Competitive hourly pay with evening/weekend differentials is offered.

Qualifications

• Strong analytical, organizational, and data-entry skills.

Responsibilities

• Review, analyze, and process pharmacy claims with accuracy.
• Identify discrepancies, investigate claim issues, and determine resolutions.
• Communicate with pharmacies, providers, and internal teams to clarify information and resolve errors.
• Support audits and quality reviews with detailed claim documentation.
• Identify trends to improve claim accuracy and efficiency.
• Uphold HIPAA and corporate policy compliance.

Skills

Analytical skills

Organizational skills

Data-entry

Communication

Attention to detail

Education

High School or better

Associates or better

Tools

Microsoft Office Suite

Job description

StateServ is seeking a Pharmacy Claims Representative in Mesa, AZ to review, analyze, and process pharmacy claims in a remote call center environment. You will ensure accuracy, resolve discrepancies, and maintain compliance with HIPAA and company standards.

The role requires 1+ year in pharmacy claims billing or healthcare operations, with proficiency in claims processing platforms and Microsoft Office. Competitive hourly pay with evening/weekend differentials is offered.