Rare Disease Claims Specialist

1 week ago


Pittsburgh, Pennsylvania, United States Pantherx Specialty LLC Full time
Job Overview

We are seeking a skilled Rare Disease Claims Specialist to join our team at Pantherx Specialty LLC.

About the Role

This is an exciting opportunity to work in the healthcare industry, specifically in the field of rare disease pharmacy. As a Rare Disease Claims Specialist, you will be responsible for verifying patient pharmacy and medical claims accurately and quickly. You will liaise between patients, insurance companies, and government agencies to ensure that patients receive medication accurately and timely, and the appropriate entity is being billed.

The ideal candidate will have a strong understanding of pharmacy claims processing and be proficient in using EDS billing systems, Excel, and Word. They will also possess excellent written and verbal communication skills, as well as the ability to multitask and work in a fast-paced environment.

Responsibilities
  • Verify patient pharmacy and medical coverage & processing info.
  • Process pharmacy claims on the patient's behalf through a pharmacy benefit system.
  • Verify medical benefits accurately on patient's behalf.
  • Obtain authorizations & overrides as needed.
  • Apply patients for copay cards and/or assistance programs.
  • Discuss with patient to review patient financial responsibility, obtain patient consent and payment.
  • Ensure proper shipment set up.
  • Work special projects.
  • Attend staff meetings.
Requirements
  • High school diploma or general education degree (GED).
  • Minimum 2 years' experience processing pharmacy claims.
  • Strong written and verbal communication skills necessary to convey ideas professionally and effectively.
  • Ability to multitask.
  • Proficient with EDS billing systems, Excel, and Word.
Salary and Benefits

The estimated annual salary for this role is $55,000 - $65,000, depending on experience. We offer a comprehensive benefits package, including medical, dental, vision, health savings and flexible spending accounts, 401K with employer matching, employer-paid life insurance and short/long term disability coverage, and an Employee Assistance Program. Generous paid time off is also available to all full-time employees.

Why Join Our Team?

At Pantherx Specialty LLC, we pride ourselves on providing uncompromising quality every day. We are committed to achieving superior health outcomes for people living with rare and devastating diseases. If you share our passion for delivering exceptional patient care and are looking for a challenging and rewarding career opportunity, we encourage you to apply.



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