Claims Specialist Near Rochester NY (MUST have Pharmacy Technician experience)

Rochester, NY
RPh on the Go Pharmacy - Pharmacy Technician Contract To Hire 9 days ago Apply

Join our Long-Term Care Mail Order Pharmacy team as a Claims Specialist and play a key role in ensuring accurate and timely reimbursement for pharmacy claims. This is a fantastic opportunity for detail-oriented professionals with a background in pharmacy and customer service.

Key Responsibilities:

  • Investigate and resolve rejected pharmacy claims to secure maximum payer reimbursement.
  • Analyze claims issues and collaborate with Medicare D plans, Medicaid plans, and third-party insurers to resolve billing discrepancies.
  • Perform edits or reversals to facilitate claim approvals and reduce financial risks.
  • Identify, document, and address trends in billing and reimbursement issues.
  • Assist with payer setup and ensure accurate billing and rebilling processes.

    Qualifications:

  • Previous pharmacy technician experience is required.
  • Strong customer service skills.
  • Ability to retain and apply knowledge in a fast-paced environment.
  • Proficient in Microsoft Office Suite and basic math skills.
  • Preferred: Knowledge of insurance industry trends and pharmacy technician licensure.

    Compensation: $18-20 / hour depending on experience
    Shift: Monday - Friday 1 PM - 9 PM

    Why RPh on the Go?
    RPh on the Go connects skilled professionals with career opportunities tailored to their expertise. Enjoy a supportive environment, competitive pay, and opportunities for growth.

    Apply Today!
    Contact [email protected] to submit your application.

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