Remote Pharmacy Reimbursement Specialist – Claims & Auths

Absolute Companies; Massillon (OH); Hybrid; USD 28,000 - 39,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Paid Time Off

Holidays

Shift differential after 5pm

Job summary

Absolute Companies in Massillon, OH is seeking a detail-oriented Pharmacy Adjudication / Reimbursement Specialist to join our Long Term Care Pharmacy team. The role focuses on accurate billing, insurance verifications, and resolving claims to ensure payer compliance.

The ideal candidate will have pharmacy technician registration, Certification within 1 year, and strong communication skills to handle calls and prior authorizations, with a commitment to quality service.

Qualifications

• State registration is required.
• Pharmacy Technician Certification 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 both 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

Attention to detail

Written and verbal communication

Multitasking

Independent and team work

Microsoft Word

Microsoft Excel

Education

Pharmacy Technician Certification

State Pharmacy Registration

Tools

Electronic claims submission

Job description

Absolute Companies in Massillon, OH is seeking a detail-oriented Pharmacy Adjudication / Reimbursement Specialist to join our Long Term Care Pharmacy team. The role focuses on accurate billing, insurance verifications, and resolving claims to ensure payer compliance.

The ideal candidate will have pharmacy technician registration, Certification within 1 year, and strong communication skills to handle calls and prior authorizations, with a commitment to quality service.