Adecco is seeking an experienced Pharmacy Claims Reimbursement Specialist for a HYBRID role in Cary, NC. Apply today!
REQUIREMENTS
-Must have 5 years’ of recent pharmacy benefits reimbursement experience including, but not limited to, Medicare and/or Medicaid program administration, insurance verification and/or claim adjudication, physicians office or outpatient billing, pharmacy and/or pharmaceutical manufacturers -(processing claims, prior authorizations)
- Must be able to analyze reimbursement specific data and prepare written reports for management and client communications.
- ICD-9, HCPCS, CPT experience
-Must have advanced data entry skills
-Must have excellent communication skills- Verbal and written
-Must have a High School Diploma or GED
-Must reside within 30-40 minutes of Cary, NC-This is not negotiable
JOB SUMMARY AND DUTIES
Work in a fast paced, high -volume contact center environment. Works closely with the healthcare providers and patients to assist with appeal management for claim denials for pharmacy benefits/prescription medications. Performs healthcare information & medical claims processing, healthcare billing & collection services, & provides financial guidance regarding hospital, HMO, clinical services to patients, their families & third-party representatives. Contact insurance companies to verify eligibility coverage for drug benefits. Function as a liaison between special drug program patients & their insurance companies. Performs healthcare information & medical claims processing, healthcare billing & collection services, & provides financial guidance regarding hospital, HMO, clinical services to patients, their families & third-party representatives. Contact insurance companies to verify eligibility coverage for drug benefits. Function as a liaison between special drug program patients & their insurance companies.
PAY- The anticipated wage for this position is between $ 19 and $20
Hourly wage depends upon experience, education, geographic location and other factors.
SCHEDULE - Monday-Friday 9am -6pm
LOCATION- Cary NC 27513- HYBRID role
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility
Pay Details: $19.00 to $20.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
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The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.