Claims Specialist — Third-Party Pharmacy Claims
Compensation
$21 – $21 /hr
Employment type
Full-time
Work setting
Remote
Location
Remote
Schedule
Day shift
Posted
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Job overview
The Claims Specialist — Third-Party Pharmacy Claims is a full-time, fully remote role; the listing identifies Vancouver, Washington, as its location. Pay is $21 per hour. The PharMerica team supports hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers through a non-retail, closed-door pharmacy environment. The specialist manages rejected pharmacy claims and works to secure accurate, timely payer reimbursement. The role helps reduce financial risk by researching claim issues, correcting billing, and coordinating with payers and internal teams.
What you'll do
- Manage and identify a portfolio of rejected pharmacy claims
- research and resolve rejected claims with Medicare Part D plans, third-party insurers, and state Medicaid plans
- perform edits or reversals to obtain claim approval
- monitor and resolve revenue risks related to payer setup and billing processes
- identify and communicate payer and billing trends
- review billing exception reports
- prepare and maintain processing reports and records.
What we're looking for
- Skills & competencies
- claims specialistthird-party claimspharmacy claimsremotevancouver wafull-timemedicare part dmedicaidpayer reimbursementclosed-door pharmacycustomer service$21/hourbrightspring health services
- Work arrangement
- Weekend coverage required
Benefits & perks
- DailyPay
- flexible schedules
- shift differentials
- health, dental, vision, and life insurance
- company-paid disability insurance
- tuition assistance and reimbursement
- employee discount program
- 401(k)
- paid time off.
Why this role
Fully remote role; pharmacy technician certification is desired but not required; high school diploma or GED required; customer service experience required.
About the employer
BrightSpring Health Services is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.
Additional details
- Industry sector
- 52
- Industry
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
- Occupation code
- 43-3021.00
You'll be redirected to the employer's application page.
Listing ID: 438a5559-d6e8-4591-9dc5-3e944485d19e