Remote Pharmacy Claims Specialist (Billing & Reimbursement)

Pharmerica; Vancouver (WA); Remote; USD 29,000 - 32,000; Full time

Benefits offered by this job

DailyPay

Flexible Schedules

Competitive Pay with Shift Differenti0

Health, Dental, Vision, and Life Ins.

Company-Paid Disability Insurance

Tuition Assistance & Reimbursement

Employee Discount Program

401k Plan

Paid Time Off

Non-Retail, Closed-Door Environment

Job summary

PharMerica is seeking a Claims Specialist to support long-term care and senior living clients in a fully remote role. You will leverage pharmacy claims experience to resolve complex reimbursements and ensure accurate billing, while collaborating with national plans and insurers.

Ideal candidates have strong customer service skills, the ability to work in a fast-paced environment, and familiarity with pharmacy operations.

Qualifications

• High School Diploma or GED required; college degree preferred.
• Customer service experience is required; pharmacy background is beneficial.
• Pharmacy technician experience preferred but not required.

Responsibilities

• Manage a portfolio of rejected pharmacy claims to maximize payer reimbursement.
• Research and resolve rejected claims with Medicare D plans, third party insurers, and state Medicaid.
• Ensure claims approval by applying edits or reversals to maximize reimbursement.
• Monitor revenue risk from payer setup, billing, rebilling and reversals.
• Collaborate to identify payer/billing trends and issues.
• Prepare reports and maintain records for processing.

Skills

Pharmacy Claims Experience

Customer Service

Fast-paced environment

Microsoft Office Suite

Education

High School Diploma or GED

Associate’s or Bachelor’s Degree

Tools

Pharmacy software

Job description

PharMerica is seeking a Claims Specialist to support long-term care and senior living clients in a fully remote role. You will leverage pharmacy claims experience to resolve complex reimbursements and ensure accurate billing, while collaborating with national plans and insurers.

Ideal candidates have strong customer service skills, the ability to work in a fast-paced environment, and familiarity with pharmacy operations.