Current jobs related to Pharmacy Claims Specialist - Louisville, Kentucky - Onco360

  • Pharmacy Claims Specialist

    2 weeks ago

    Louisville, Kentucky, United States Onco360 Full time

    Job Title: Pharmacy Adjudication SpecialistWe are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy in Louisville, KY. This is a full-time position with a hybrid work style, requiring a location within driving distance to our pharmacy.Job Summary:The Pharmacy Adjudication Specialist will be responsible for...

  • Pharmacy Claims Specialist

    3 weeks ago

    Louisville, Kentucky, United States Onco360 Full time

    Pharmacy Adjudication Specialist Job DescriptionWe are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy in Louisville, KY. This is a full-time position with two available shifts: Monday to Friday, 11:30 am to 8 pm EST and 9:30 am - 6 pm EST. The ideal candidate will be located within driving distance to our...

  • Pharmacy Care Specialist

    5 days ago

    Louisville, Kentucky, United States Apotheco Pharmacy Full time

    Apotheco Pharmacy is a leading pharmacy that has been serving the community with exceptional care and service. We are dedicated to providing a work environment that fosters a strong work-life balance, which includes evenings and weekends off, 10 days of paid time off, and 2 floating holidays.Each employee is assigned their own workstation, equipped with a...

  • Pharmacy Billing Specialist

    1 week ago

    Louisville, Kentucky, United States PharMerica Full time

    Job Summary:We are seeking a skilled Pharmacy Billing Specialist to join our team at PharMerica. As a key member of our billing team, you will be responsible for the accurate and timely adjudication of all prescriptions, onsite training of new hires as needed, and the maintenance of the pharmacy unbilled.Key Responsibilities:Ensure the accuracy and timely...

  • Pharmacy Order Entry Specialist

    2 weeks ago

    Louisville, Kentucky, United States Southern Home Care Services, Inc. Full time

    Job SummaryAs a Pharmacy Order Entry Specialist with PharMerica, you will play a critical role in ensuring the accuracy and efficiency of medication orders. Your attention to detail and organizational skills will be essential in maintaining high productivity standards while meeting accuracy requirements.Responsibilities* Triage, interpret, and input orders...

  • Pharmacy Technician Specialist

    1 week ago

    Louisville, Kentucky, United States BrightSpring Health Services Full time

    Pharmacy Technician Job SummaryWe are seeking a skilled Pharmacy Technician to join our team at BrightSpring Health Services. As a Pharmacy Technician, you will play a vital role in ensuring the accuracy and efficiency of our pharmacy operations.Key Responsibilities:Triage, interpret, and input orders into our computerized medication order system, meeting...

  • Pharmacy Technician Specialist

    2 weeks ago

    Louisville, Kentucky, United States Southern Home Care Services, Inc. Full time

    Pharmacy Technician Job SummaryAt Southern Home Care Services, Inc., we are seeking a skilled Pharmacy Technician to join our team. As a Pharmacy Technician, you will play a vital role in ensuring the accuracy and efficiency of our pharmacy operations.Key Responsibilities:Triage and interpret medication orders, accurately inputting them into our computerized...

  • Pharmacy Prior Authorization Specialist

    3 weeks ago

    Louisville, Kentucky, United States Southern Home Care Services, Inc. Full time

    About the RoleWe are seeking a skilled Prior Authorization Coordinator to join our team at PharMerica. As a Prior Authorization Coordinator, you will play a critical role in ensuring that our clients receive the necessary pharmacy services in a timely and efficient manner.Key ResponsibilitiesEnsure accurate and timely completion of client prior authorization...

  • Pharmacy Billing Specialist

    7 days ago

    Louisville, Kentucky, United States Southern Home Care Services, Inc. Full time

    Job Title: Pharmacy Billing CoordinatorAbout the Role:We are seeking a highly skilled Pharmacy Billing Coordinator to join our team at Southern Home Care Services, Inc. This is a unique opportunity to work in a dynamic and growing organization, providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals,...

  • Pharmacy Technician

    1 week ago

    Louisville, Kentucky, United States Molina Healthcare Full time

    Job SummaryMolina Healthcare is seeking a skilled Pharmacy Technician to join our team. As a Pharmacy Technician - Medication Management Specialist, you will play a critical role in ensuring that our members have access to necessary prescription medications in a safe and cost-effective manner.Key ResponsibilitiesPerform initial receipt and review of...

  • Pharmacy Prior Authorization Specialist

    4 weeks ago

    Louisville, Kentucky, United States Southern Home Care Services, Inc. Full time

    Job Title: Prior Authorization CoordinatorWe are seeking a highly skilled Prior Authorization Coordinator to join our team at PharMerica. As a Prior Authorization Coordinator, you will play a critical role in ensuring that our clients receive the necessary pharmacy services in a timely and efficient manner.Responsibilities:Ensure accurate and timely...

  • Insurance Claims Specialist

    2 weeks ago

    Louisville, Kentucky, United States Mortenson Dental Partners Full time

    Job Title: Insurance Claims SpecialistJob Summary: We are seeking a highly skilled Insurance Claims Specialist to join our team at Mortenson Dental Partners. As an Insurance Claims Specialist, you will be responsible for analyzing ERA claims that did not auto post for cause, posting insurance payments for claims with exceptions, and ensuring the accuracy of...

  • Pharmacy Technician

    2 weeks ago

    Louisville, Kentucky, United States PharMerica Full time

    Pharmacy Technician Role OverviewPharMerica is a leading provider of pharmacy services to long-term care and senior living clients. As a Pharmacy Technician, you will play a vital role in fulfilling the pharmaceutical needs of our clients. Key Responsibilities:Triage and interpret medication orders, ensuring accuracy and productivity standards are...

  • Pharmacy Order Entry Specialist

    2 weeks ago

    Louisville, Kentucky, United States Southern Home Care Services, Inc. Full time

    Pharmacy Order Entry Technician Job DescriptionJob Summary:We are seeking a highly skilled Pharmacy Order Entry Technician to join our team. As a Pharmacy Order Entry Technician, you will be responsible for accurately and efficiently entering medication orders into our computerized system, ensuring timely and accurate processing of...

  • Pharmacy Billing Specialist

    2 weeks ago

    Louisville, Kentucky, United States Trilogy Health Services Full time

    Job SummaryWe are seeking a highly skilled Pharmacy Billing Associate to join our team at Trilogy Health Services. As a Pharmacy Billing Associate, you will be responsible for processing and ensuring the accuracy of invoices to customers, as well as providing assistance to healthcare professionals with Medicare, Medicaid, and other insurance claims.Key...

  • Pharmacy Technician

    2 months ago

    Louisville, Kentucky, United States Healthcare Consultants - Pharmacy Staffing Full time

    Pharmacy Technician Job DescriptionWe are seeking a skilled Pharmacy Technician to join our team at Healthcare Consultants - Pharmacy Staffing. As a Pharmacy Technician, you will play a vital role in assisting staff pharmacists in filling prescriptions and handling cash register transactions.Key Responsibilities:Medication Management: Count, sort, and label...

  • Pharmacy Billing Specialist

    1 week ago

    Louisville, Kentucky, United States Trilogy Health Services Full time

    Job SummaryWe are seeking a highly skilled Pharmacy Billing Associate to join our team at Trilogy Health Services. As a Pharmacy Billing Associate, you will be responsible for processing and ensuring the accuracy and timely issuance of invoices to customers. You will also provide healthcare professionals with assistance with Medicare, Medicaid, Prescription...

  • Pharmacy Technician

    2 weeks ago

    Louisville, Kentucky, United States BrightSpring Health Services Full time

    Job SummaryWe are seeking a highly skilled Pharmacy Technician to join our team at PharMerica. As a Pharmacy Technician, you will play a critical role in ensuring the accurate and efficient processing of medication orders for our long-term care and senior living clients.Key Responsibilities:Triage and interpret medication orders, ensuring accuracy and...

  • Pharmacy Billing Specialist

    2 weeks ago

    Louisville, Kentucky, United States Medix Full time

    Pharmacy Billing Associate Job DescriptionLocation: Louisville, KYOverview:We are seeking highly skilled Pharmacy Billing Associates to join our team at Medix. This is an excellent opportunity for Pharmacy Technicians looking to transition into the billing side of the industry.Responsibilities:Handle customer interactions via phone, both inbound and...

  • Pharmacy Automation Specialist

    2 weeks ago

    Louisville, Kentucky, United States Baptist Health Full time

    Job Title: Pharmacy Automation SpecialistJob Summary: Baptist Health is seeking a highly skilled Pharmacy Automation Specialist to join our Central Pharmacy team in LaGrange, KY.As a Pharmacy Automation Specialist, you will work closely with other technology departments to ensure seamless integration of automation systems.You will be responsible for managing...

Pharmacy Claims Specialist

2 months ago

Louisville, Kentucky, United States Onco360 Full time
Job Summary

We are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy in Louisville, KY. As a Pharmacy Adjudication Specialist, you will play a critical role in ensuring the accurate and timely processing of pharmacy claims, resolving third-party rejections, and providing exceptional customer service to our patients and healthcare providers.

Key Responsibilities
  • Adjudicate pharmacy claims, review claim responses for accuracy, and ensure prescription claims are processed correctly according to the coordination of benefits.
  • Resolve third-party rejections, obtain overrides if necessary, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections.
  • Provide thorough, accurate, and timely responses to requests from pharmacy operations, providers, and/or patients regarding active claims information.
  • Ensure complete and accurate patient setup in CPR+ system, including patient demographic and insurance information.
  • Adjudicate pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and review claim responses for accuracy before accepting the claim.
  • Contact insurance companies to resolve third-party rejections and ensure pharmacy claim rejections are resolved to allow for timely shipping of medications.
  • Perform outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays.
  • Ensure copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible).
  • Manage all funding-related adjudications and work as a liaison to Onco360 Advocate team.
  • Assist pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment.
  • Serve as customer service liaison to patients regarding financial responsibility prior to shipments, contact patients to communicate any copay discrepancy between quoted amount and claim, and collect payment if applicable.
  • Document and submit requests for Patient Refunds when appropriate.
Requirements
  • High School Diploma or GED.
  • Previous experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication.
  • Associate degree or equivalent program from a 2-year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience.
  • 1+ years of experience in Pharmacy/Healthcare Setting or pharmacy claims experience.
  • 3+ years of experience in Pharmacy/Healthcare Setting or pharmacy claims experience.
  • Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.
  • Registration with Board of Pharmacy as required by state law.
  • Certified Pharmacy Technician (PTCB).
Behavior Competencies
  • Independent worker.
  • Good interpersonal skills.
  • Excellent verbal and written communications skills.
  • Ability to work independently.
  • Work efficiently to meet deadlines and be flexible.
  • Detail-oriented.
  • Great time-management skills.