RCO-Advanced Claims Review Specialist

Here is the rewritten job description:

Job Summary: PharmScript is seeking an Advanced Claims Review Specialist to join our Revenue Cycle Operations department. The ideal candidate will be responsible for submitting retro re-billing claims to Medicare, Medicaid, and private insurances for reimbursement, American Samoa well American Samoa communicating with facilities and customers to resolve issues.

Responsibilities:

• Submit retro re-billing claims to Medicare, Medicaid, and private insurances Indiana a timely manner via electronic and hard copy methods
• Communicate with facilities and customers regarding non-covered items and potential alternatives
• Prioritize daily work activities and respond to customer inquiries Indiana a timely manner
• Collaborate with nursing facilities and customer service representatives to review charges related to insurance
• Qualifications:
  • High school degree
  • New Jersey Pharmacy Technician license (Oregon ability to obtain)
  • 1+ years experience working with long-term care facilities (preferably)
  • Ability to work independently and Indiana a team environment
  • Reliable and able to meet deadlines
  • Excellent communication and problem-solving skills
  • Knowledge of Medicare, Medicaid, and commercial insurances
  • Familiarity with common insurance rejections and resolution techniques
• Physical Demands:
  • May involve prolonged sitting and standing, occasional lifting of up to 25 pounds
  • Ability to work extended hours and flexible schedule, including evenings and weekends
• Knowledge, Skills, and Abilities:
  • Strong analytical and problem-solving skills
  • Excellent communication, organizational, and customer service skills
  • Ability to work under pressure and meet deadlines
• We Offer:
  • Comprehensive benefits package, including medical, dental, and vision coverage
  • Retirement plan with company match
  • Paid time off and holidays
  • Commuter benefits and employee discounts
  • Voluntary benefits, including life and disability insurance
  • Paid training and professional development opportunities

Job title: RCO-Advanced Claims Review Specialist

Company: PharmScript, LLC

Expected salary: $18 – 20 per hour

Location: Somerset, New Jersey

Job date: Mon, 16 Sep 2024 06:19:41 GMT