Remote Pharmacy Reimbursement Specialist – Adjudication

Absolute Health Services; Massillon (OH); Remote; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Paid time off

Holidays

Shift differential after 5pm

Job summary

Absolute Health Services in Massillon, OH seeks a Pharmacy Adjudication / Reimbursement Specialist to ensure accurate billing for prescriptions. You will verify patient and insurance information, submit claims, and resolve payer issues in a fast-paced long-term care pharmacy setting.

Join a team focused on compliance, timely reimbursements, and quality documentation. Prior pharmacy tech experience and MS Word/Excel skills are valued, with remote shift options and competitive benefits.

Qualifications

• State registration required.
• Pharmacy Technician Certification required within 1 year of hire.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication skills.
• Ability to multitask and manage competing priorities.
• Self-motivated with the ability to work independently and as part of a team.
• Basic proficiency in Microsoft Word and Excel.

Responsibilities

• Verify patient demographics and insurance information for accuracy.
• Submission of claims to Insurance Companies electronically.
• Perform insurance verifications and eligibility checks.
• Handle inbound and outbound calls with facilities, guarantors, and insurance companies.
• Initiate and follow up on prior authorizations.
• Review and respond to insurance audit requests.
• Investigate and resolve insurance and Medicaid rejections.
• Maintain accurate documentation of all billing activities.
• Perform other duties as assigned.

Skills

State registration

Pharmacy Technician Certification

Attention to detail

Organizational skills

Communication skills

Multitasking

MS Word

MS Excel

Job description

Absolute Health Services in Massillon, OH seeks a Pharmacy Adjudication / Reimbursement Specialist to ensure accurate billing for prescriptions. You will verify patient and insurance information, submit claims, and resolve payer issues in a fast-paced long-term care pharmacy setting.

Join a team focused on compliance, timely reimbursements, and quality documentation. Prior pharmacy tech experience and MS Word/Excel skills are valued, with remote shift options and competitive benefits.