Remote Reimbursement Specialist I — Copay & Claims

Lumicera; Harrisburg (Dauphin County); Remote; USD 42,000 - 60,000; Full time

Benefits offered by this job

Health, Dental, Vision Insurance

Paid Time Off 20 days

4 weeks parental leave

9 holidays

401K match up to 5%

Adoption Assistance

Flexible Spending Account

Educational Assistance Plan and Pro/Mt

Professional Membership assistance

Referral Bonus up to $750

Job summary

Navitus Health Solutions is seeking a Reimbursement Specialist I to join our team. The role focuses on processing manufacturer copay assistance reimbursements and ensuring accurate billing within our pharmacy software.

You may contact patients with outstanding balances to discuss billing options and resolve discrepancies. Ideal candidates have a High School Diploma (GED) with pharmacy claims experience; CPhT or pharmacy technician licensure is preferred.

Qualifications

• High School Diploma or GED; some college preferred.
• CPhT preferred.
• Pharmacy technician license or trainee license preferred where licensure is required.
• Experience with pharmacy, health plan or clinical insurance claims billing or claims auditing is preferred.
• Compliance program participation and cooperative attitudes are expected.

Responsibilities

• Monitor claims activity for accuracy and submission.
• Ensure patient billing info is set up in pharmacy software.
• Participate in reimbursement/billing conferences and meetings.
• Respond to questions/complaints about reimbursement or billing.
• Work with internal teams to resolve claim issues.
• Maintain reference information on reimbursement and copay assistance.
• Document patient information, insurance, prescriptions in profiles.
• Comply with all laws and uphold high ethical standards.
• Other duties as assigned.

Skills

Pharmacy claims billing experience

Insurance claims documentation

Customer service / communication

Attention to detail

Education

High School Diploma or GED

Some college

CPhT preferred

Pharmacy technician license or trainee license preferred

Job description

Navitus Health Solutions is seeking a Reimbursement Specialist I to join our team. The role focuses on processing manufacturer copay assistance reimbursements and ensuring accurate billing within our pharmacy software.

You may contact patients with outstanding balances to discuss billing options and resolve discrepancies. Ideal candidates have a High School Diploma (GED) with pharmacy claims experience; CPhT or pharmacy technician licensure is preferred.