Reconciliation Specialist

**I. **

EPIC Pharmacy Network (EPN) is currently seeking a self-motivated professional to review pharmacy claim records, research problems, & correspond with payers, insurance carriers and pharmacies to resolve non-payment and underpayment discrepancies.

**II. POSITION EXPECTATIONS**
- Serve as initial point of contact for inquiries regarding pharmacy payments from both payers and pharmacies.
- Responsible to for tracking issues associated with claim underpayment and non payment and reporting to team members, including management.
- Responsible for resolving underpayment and non payment of pharmacy claims.
- Ensure data integrity of all information being sent to PBMs, health plans and pharmacies.
- Manually reconcile claims for pharmacies who have elected EPNs enhanced reconciliation program.
- Run all reports needed to successfully manage the claims payments for PBMs, health plans and pharmacies.
- Improve underpayment and non-payment claims process thru strategy and process improvements.
- Attend internal and external other assigned training and meetings to improve knowledge base and claims processing efficiencies and effectiveness.
- Complete special projects and perform other duties and responsibilities as required.

**III. MINIMUM QUALIFICATIONS & SKILLS**

**Education, Certifications and /or Licenses**:

- Associates degree in a related field or any combination of education and experience, which would provide an equivalent background
- Pharmacy Technician Certification Preferred.

**Experience**:

- 1-3 years in health care experience in claims reconciliation.
- Experience in customer service.

**Knowledge/Skills**:

- Proficient with Microsoft Office suite and services
- Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills and analytic skills.
- Ability to work independently in a rapid pace environment
- Self-starter capable of managing multiple projects at once

**V. PHYSICAL DEMANDS**
- Remaining in a stationary position, often standing, or sitting for prolonged periods.
- Moving about to accomplish tasks or moving from one worksite to another.
- Communicating with others to exchange information
- Repeating motions that may include the wrists, hands and/or fingers

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

EPIC Rx provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

EPIC Pharmacy Network is a wholly owned subsidiary of EPIC Pharmacies formed in 1992, the EPIC Pharmacy Network represents more than 1600 independent pharmacies in providing centralized services in the managed care segment of pharmacy.

Pay: From $20.00 per hour

**Benefits**:

- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- Work from home

Physical setting:

- Office

Schedule:

- 8 hour shift
- Monday to Friday

Ability to Commute:

- Mechanicsville, VA 23116 (preferred)

Work Location: Hybrid remote in Mechanicsville, VA 23116