Requisition: 2024-134024

　　CLAIMS SPECIALIST - 3RD PARTYJob Locations

　　US-PA-HORSHAMID2024-134024

　　Line of BusinessPharMerica

　　Position TypeFull-Time

　　Our Company

　　PharMericaOverview

　　Join our PharMerica team!  PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients.  We offer a non-retail pharmacy environment.  Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!Schedule: Mon-Fri 11:00am-7:30pm Rotating Every Other Weekend 9:00am-5:30pm

　　We offer:

　　DailyPayFlexible schedulesCompetitive payShift differentialHealth, dental, vision and life insurance benefitsCompany paid STD and LTDTuition AssistanceEmployee Discount Program401kPaid-time offTuition reimbursementNon-retail/Closed-door environment

　　Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!

　　Responsibilities

　　The Claims Specialist - 3rd Party:Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risksResearches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlinesEnsures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursementMonitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processesWorks as a team to identify, document, communicate and resolve payer/billing trends and issuesReviews and works to convert billing exception reports to ensure claims are billed to accurate financial plansPrepares and maintains reports and records for processingPerforms other tasks as assigned

　　Qualifications

　　Education/Learning Experience:Required: High School Diploma or GEDDesired: Associate's or Bachelor's DegreeWork Experience:Required: Customer ServiceDesired: Up to one year of related experience. Pharmacy Technician experienceSkills/Knowledge:Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office SuiteDesired: Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsettersLicenses/Certifications:Desired: Pharmacy technician, but not required

　　About our Line of Business

　　PharMerica is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica isone of the nation'slargest pharmacy companies. PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about PharMerica, please visitwww.pharmerica.com. Follow us onFacebook,Twitter, and LinkedIn.

　　Additional Job Information

　　This is an excellent opportunity to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.

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　　Res-Care, Inc., dba BrightSpring Health Services ("ResCar "), is an Equal Opportunity Employer. ResCare does not discriminate against any person on the basis of gender, race, color, national origin, religion, disability, age, veteran status, gender identity or sexual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.