Remote Pharmacy Claims Specialist – Reimbursement & Billing

BrightSpring Health Services Corporation; Louisville (KY); Remote; USD 45,000 - 65,000; Full time

Benefits offered by this job

DailyPay

Flexible schedules

Competitive pay with shift different

Health, dental, vision, life insurance

401k plan

Paid time off

Non-retail, closed-door environment

Job summary

PharMerica is seeking a Claims Specialist to manage and resolve 3rd party pharmacy claims in a fully remote role across the United States. You will work on payer reimbursements, billing accuracy, and customer service, supporting long-term care and senior living clients.

The position emphasizes claims research, fast-paced processing, and collaboration with national plans; Pharmacy Technician experience is a plus. Comprehensive benefits and flexible schedules are offered.

Qualifications

• Required: High School Diploma or GED
• Desired: Associate's or Bachelor's Degree
• Experience in customer service or pharmacy helpful

Responsibilities

• Manages a portfolio of rejected pharmacy claims to maximize payer reimbursement and timely billing
• Researches and resolves rejected claims with Medicare D plans, third-party insurers and Medicaid
• Performs edits/reversals to ensure approval and maximize reimbursement
• Monitors revenue at risk from payer setup, billing, rebilling and reversal processes
• Documents payer/billing trends and issues and collaborates with team to resolve them
• Prepares and maintains reports for processing

Skills

Customer Service

Fast-paced environment

Basic math

Microsoft Office Suite

Education

High School Diploma or GED

Associate's or Bachelor's Degree

Tools

Microsoft Office Suite

Job description

PharMerica is seeking a Claims Specialist to manage and resolve 3rd party pharmacy claims in a fully remote role across the United States. You will work on payer reimbursements, billing accuracy, and customer service, supporting long-term care and senior living clients.

The position emphasizes claims research, fast-paced processing, and collaboration with national plans; Pharmacy Technician experience is a plus. Comprehensive benefits and flexible schedules are offered.