Pharmacy Technician- Claims Specialist- Honolulu, HI
3 weeks ago
RPh on the Go is looking for a pharmacy technician to add to our claims specialist team in Aiea, HI. This is an 8-week temp to perm positionand were interviewing to start ASAP. Technician trainees are welcome to apply
Shifts:
Monday - Saturday 9am- 5:30pm.
(If they work a Saturday, will get a week day off).
Essential Duties:
- 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:
- Pharmacy technician experience,.
- Long term care experience a plus.
- Experience with Adjudication preferred
How to Apply:
Interested candidates are invited to send an updated resume to or call at for immediateconsideration.
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