Remedi SeniorCare

Reject Specialist

Location US-OH-Euclid
Job ID
Functional Area


The Reject Specialist is responsible for accurate and timely reject resolution.


  • Monitor and resolve rejected claims appearing on pharmacy system Dashboard for assigned pharmacy.
  • Become familiar with each pharmacy’s policies and procedures regarding claims management.
  • Knowledge of third party policies and NCPDP standard for claim submission.
  • Communicates with other departments on claim related matters.
  • Complies and enforces all company and departmental policies and procedures.
  • Complies with all applicable state and federal regulations related to pharmacy and claim billing practices.
  • Responsible with achieving department goals in volume, production, quality, customer service.
  • Direct claims to other departments for resolution as deemed necessary
  • Identify trending by recognizing problem areas for pharmacies that may reduce rejections when corrected.


  • High school diploma or GED equivalent.  Proficient in Excel, Word and Outlook required, general knowledge and understanding of third party claim submission
  • Minimum of two years medical billing or third party claim submission desired.  Previous LTC pharmacy billing preferred.
  • Must be able to communicate effectively both verbally and in writing. Individual must have a strong internal and external customer service focus, and work as a team player.


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