Remote Reimbursement Specialist I | Copay & Claims

Lumicera; Jefferson City (MO); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Health coverage

PTO 20 days

Parental leave 4 weeks

9 paid holidays

401K match up to 5%

Adoption assistance

FSAs

Education assistance

Referral bonus

Job summary

Lumicera Health Services seeks a Reimbursement Specialist I to join our team. Under direction from the Assoc.

Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, you will process copay assistance reimbursements and monitor claims activity, ensuring accurate patient billing in the pharmacy software. Ideal candidates have a High School Diploma or GED (CPhT preferred) and experience with pharmacy billing, claims, and compliance.

Qualifications

• High School Diploma or equivalent GED. Some college preferred.
• CPhT preferred
• Pharmacy technician license or trainee license is strongly preferred in states requiring pharmacy technician licensure
• Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

Responsibilities

• Responsible for ongoing monitoring of claims activity for accuracy and successful submission
• Responsible for ensuring that patient billing information is set up appropriately in the pharmacy software
• Participate, as necessary, in conferences and meetings related to reimbursement/billing
• Responds to employee/patient/client questions or complaints regarding reimbursement and/or billing
• Works with internal teams to review and resolve claim issues
• Maintains accurate reference information relating to reimbursement and copay assistance
• Responsible for accurate and thorough documentation of information, insurance and prescriptions/orders within the patient profile
• The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee
• Other duties as assigned

Skills

Pharmacy claims billing

Compliance

Interpersonal communication

Education

High School Diploma or GED

Tools

Pharmacy software

Job description

Lumicera Health Services seeks a Reimbursement Specialist I to join our team. Under direction from the Assoc.

Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, you will process copay assistance reimbursements and monitor claims activity, ensuring accurate patient billing in the pharmacy software. Ideal candidates have a High School Diploma or GED (CPhT preferred) and experience with pharmacy billing, claims, and compliance.