Remote Reimbursement Specialist I - Pharmacy Claims

Lumicera; Montgomery (AL); In loco; USD 42.000 - 64.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health, Dental, Vision insurance

Paid time off

Parental leave

Holidays

401K company match

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Professional Membership assistance

Referral Bonus Program

Descrizione del lavoro

Lumicera Health Services is seeking a Reimbursement Specialist I to join our team. This role focuses on processing copay assistance program reimbursements, ensuring accurate billing, and reducing discrepancies in claims.

Under direction from leadership, the specialist will monitor claims, maintain patient billing data in the pharmacy system, and support compliance with federal and state laws. Strong communication with patients and internal teams is essential.

Competenze

• High School Diploma or GED; some college preferred.
• CPhT preferred and pharmacy technician license or trainee license is preferred where licensure applies.
• Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred.
• Commitment to compliance and high ethical standards; able to interact cooperatively with others.

Mansioni

• Monitor claims activity for accuracy and successful submission.
• Ensure patient billing information is set up correctly in the pharmacy software.
• Participate in conferences/meetings related to reimbursement and billing.
• Respond to questions or complaints regarding reimbursement and/or billing.
• Work with internal teams to review and resolve claim issues.
• Maintain accurate reference information related to reimbursement and copay assistance.
• Document information, insurance, and prescriptions/orders in the patient profile.
• Uphold legal and ethical compliance in all duties.
• Other duties as assigned.

Formazione

High School Diploma or GED

Some college

CPhT preferred

Pharmacy technician license/trainee license preferred

Strumenti

Pharmacy software

Descrizione del lavoro

Lumicera Health Services is seeking a Reimbursement Specialist I to join our team. This role focuses on processing copay assistance program reimbursements, ensuring accurate billing, and reducing discrepancies in claims.

Under direction from leadership, the specialist will monitor claims, maintain patient billing data in the pharmacy system, and support compliance with federal and state laws. Strong communication with patients and internal teams is essential.