ResCare Community Living

Pharmacy Claims Specialist


PayCompetitive
LocationArlington/Texas
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: 146808
      Employer Industry: Pharmacy Services

      Why Consider this Job Opportunity:
      - Competitive pay
      - Opportunity for career advancement and growth within the organization
      - Flexible schedules
      - Remote work opportunity
      - Health, dental, vision, and life insurance benefits
      - Tuition Assistance and Tuition reimbursement

      What to Expect (Job Responsibilities):
      - Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing
      - Research, analyze, and resolve rejected claims with national Medicare D plans, third party insurance companies, and state Medicaid plans
      - Monitor and resolve at-risk revenue associated with payer set up, billing, rebilling, and reversal processes
      - Identify, document, communicate, and resolve payer/billing trends and issues
      - Prepare and maintain reports and records for processing

      What is Required (Qualifications):
      - High School Diploma or GED
      - Customer Service experience
      - Ability to retain a large amount of information and apply that knowledge to related situations
      - Basic math aptitude
      - Microsoft Office Suite skills

      How to Stand Out (Preferred Qualifications):
      - Up to one year of related experience
      - Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations, and trendsetters

      #PharmacyServices #CareerOpportunity #RemoteWork #CompetitivePay #HealthcareServices

      We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

Notice

Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.

Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.

An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.