Remedi SeniorCare

  • Claims Specialist

    Location US-OH-Euclid
    Job ID
    2018-1850
    Functional Area
    Billing
  • Overview

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

    Responsibilities

    • 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.

    Qualifications

    • 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.

     

    WHY REMEDI?

     

    Remedi SeniorCare is one of the nation’s TOP TEN long term care pharmacies. We offer nursing homes and assisted-living facilities everything they need to provide better care to their residents by delivering highly responsive pharmacy solutions.

     

    Remedi SeniorCare is currently looking for enthusiastic, motivated and talented individuals to join its Pharmacy Operations team. Our Pharmacy delivers life-saving medications to thousands of residents every day across Ohio. Our team members enjoy climate-controlled state-of-the-art facility equipped with customer-inspired innovative technologies.

     

    Remedi offers great benefits and perks that include health, vision, and dental insurance, flexible spending and health savings account, life insurance/long- and short-term disability, and a 401K match!

     

    #ZR

     

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