BrightSpring Health Services
ADJUDICATOR, POINT OF SALE
BrightSpring Health Services, Taunton, Massachusetts, us, 02780
ADJUDICATOR, POINT OF SALEJob Locations:
US-MA-TAUNTONID:
2024-145837Line of Business:
PharMericaPosition Type:
Full-TimePay Range:
USD $19.00 - $26.00/Hr.Our Company:PharMericaOverview:Our
Point of Sale Adjudicators
are crucial to our 3rd Party Claims activities and our business. This is an excellent opportunity to move from a retail pharmacy to an 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. This is a
REMOTE
position and can work from anywhere in the continental United States.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:
Monday-Friday 9am - 5:30pm CSTWe 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: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 risks.Researches, 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 deadlines.Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement.Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes.Works as a team to identify, document, communicate and resolve payer/billing trends and issues.Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans.Prepares and maintains reports and records for processing.Performs 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 Suite.Desired: Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters.Licenses/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 is one of the nation's largest 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 visit
www.pharmerica.com . Follow us on
Facebook ,
Twitter , and
LinkedIn .Salary Range:
USD $19.00 - $26.00 / Hour
#J-18808-Ljbffr
US-MA-TAUNTONID:
2024-145837Line of Business:
PharMericaPosition Type:
Full-TimePay Range:
USD $19.00 - $26.00/Hr.Our Company:PharMericaOverview:Our
Point of Sale Adjudicators
are crucial to our 3rd Party Claims activities and our business. This is an excellent opportunity to move from a retail pharmacy to an 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. This is a
REMOTE
position and can work from anywhere in the continental United States.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:
Monday-Friday 9am - 5:30pm CSTWe 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: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 risks.Researches, 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 deadlines.Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement.Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes.Works as a team to identify, document, communicate and resolve payer/billing trends and issues.Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans.Prepares and maintains reports and records for processing.Performs 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 Suite.Desired: Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters.Licenses/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 is one of the nation's largest 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 visit
www.pharmerica.com . Follow us on
Facebook ,
Twitter , and
LinkedIn .Salary Range:
USD $19.00 - $26.00 / Hour
#J-18808-Ljbffr