Claims Specialist
5 days ago
We are seeking a highly skilled Claims Specialist to join our team at BrightSpring Health Services. As a Claims Specialist, you will play a critical role in ensuring our clients receive the pharmaceutical support they need.
Key Responsibilities- Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks.
- Research, analyze, and resolve rejected claims by working with national Medicare D plans, third-party insurance companies, and state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines.
- Ensure approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement.
- Monitor and resolve at-risk revenue associated with payer setup, billing, rebilling, and reversal processes.
- Work as a team to identify, document, communicate, and resolve payer/billing trends and issues.
- Review and work to convert billing exception reports to ensure claims are billed to accurate financial plans.
- Prepare and maintain reports and records for processing.
- High School Diploma or GED.
- Customer Service experience.
- Ability to retain a large amount of information and apply that knowledge to related situations.
- Basic math aptitude.
- Microsoft Office Suite.
BrightSpring Health Services is a leading provider of pharmacy services to senior living communities, skilled nursing facilities, public health organizations, and post-acute care organizations. We offer a dynamic work environment, opportunities for growth and development, and a commitment to excellence in patient care.
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Claims Processing Specialist
2 weeks ago
Taunton, Massachusetts, United States BrightSpring Health Services Full timeCompany Overview BrightSpring Health Services Position Summary As a Claims Processing Specialist, you will play a vital role in our third-party claims operations. This position offers a unique opportunity for individuals transitioning from retail pharmacy settings to a professional office environment, where you will gain valuable experience in claims...
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Claims Specialist
3 days ago
Taunton, Massachusetts, United States BrightSpring Health Services Full timeAbout the RoleWe are seeking a highly skilled Claims Specialist - 3rd Party to join our team at BrightSpring Health Services. As a Claims Specialist, you will play a critical role in ensuring maximum payer reimbursement and timely billing to eliminate financial risks.Key ResponsibilitiesManage and identify a portfolio of rejected pharmacy claims to ensure...
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Claims Specialist
6 days ago
Taunton, Massachusetts, United States BrightSpring Health Services Full timeAbout the RoleWe are seeking a highly skilled Claims Specialist - 3rd Party to join our team at BrightSpring Health Services. As a Claims Specialist, you will play a critical role in ensuring maximum payer reimbursement and timely billing to eliminate financial risks.Key ResponsibilitiesManage and identify a portfolio of rejected pharmacy claims to ensure...
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Claims Specialist
10 hours ago
Taunton, Massachusetts, United States Amerita Full timeAbout the RoleAmerita is seeking a highly skilled Claims Specialist - 3rd Party to join our team. As a Claims Specialist, you will play a critical role in ensuring maximum payer reimbursement and timely billing to eliminate financial risks.Key ResponsibilitiesManage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement...
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Claims Processing Specialist
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Pharmacy Order Processing Specialist
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Pharmacy Order Processing Specialist
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Pharmacy Order Processing Specialist
2 weeks ago
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Pharmacy Order Processing Specialist
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File Management Specialist
2 weeks ago
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Patient Care Coordinator I
2 weeks ago
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Patient Care Coordinator
1 week ago
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