Requisition: 2023-132138CLAIMS SPECIALISTJob LocationsUS-WA-VANCOUVERID2023-132138Line of BusinessPharMericaPosition TypeFull-TimePay MinUSD $22.00/Hr.Pay MaxUSD $23.00/Hr.Our CompanyPharMericaOverviewJoin 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!We are seeking individuals who have experience in Pharmacy who are ready to make a change. This is an excellent opportunity for Pharmacy Technicians to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.This is a remote position and applicants can reside anywhere within the continental USASchedule: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 environmentOur 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* Training inclusive auditing for accuracy of claim processing and working with team on training documents* Third Party Claims processing and payer subject matter expert* Provide support to 3rd Party Claims Specialist I answering operational questions* Support supervisory team by monitoring 3rd party at risk revenue* Support supervisory team with managing work queue* Review/resolve elevated issues* Complete quality assessment review of staff transactions* Work as a team to identify, document, communicate and resolve payer/billing trends and issues* Provide feedback to supervisor on staff performance* Prepares and maintains reports and records for processing.* Back up support for all operational functions of team including but not limited to research, analyze and appropriately resolve 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 deadlines.* Review and code revenue adjustments and/or write offs for management review and approval* Establish payer relationships to support operations* Performs other tasks as assigned.* Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.* To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.QualificationsEducation/Learning Experience* Required: High School Diploma or GED* Desired: Associate's or Bachelor's DegreeWork Experience* Required: Customer Service. Up to 2 year