Pharmacy Technician- Claims Specialist- Honolulu, HI

3 weeks ago


Honolulu, United States RPh on the Go Full time
Job DescriptionJob DescriptionMinimum 1+ years pharmacy experience required.

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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