Claims Specialist

Job not on LinkedIn

🔥 15 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Okta

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 2010

🔐 Security

🏢 Enterprise

☁️ SaaS

Security • Enterprise • SaaS

Okta is a leading provider of identity management solutions, offering both Customer Identity and Workforce Identity Clouds to ensure seamless and secure access for organizations across various industries. With a focus on flexibility, neutrality, and extensibility, Okta enables businesses to create high-performing IT systems and optimized digital experiences while maintaining top-notch security. Their platform supports a wide range of use cases including single sign-on, multifactor authentication, and identity governance, helping companies across sectors like finance, healthcare, government, and retail to manage identities efficiently. Okta continues to lead in identity access management, as highlighted by its recognition in the Gartner Magic Quadrant.

📋 Description

• Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need. • Be a vital part of a team that’s dedicated to enhancing patient care through meticulous claims management and customer service. • 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.

🎯 Requirements

• High School Diploma or GED • Desired: Associate’s or Bachelor’s Degree • Required: Customer Service • Desired: Up to one year of related experience. • Pharmacy Technician experience • Required: Ability to retain a large amount of information and apply that knowledge to related situations. • Ability to work in a fast-paced environment. • Basic math aptitude. • Microsoft Office Suite • Desired: Knowledge of the insurance industry’s trends, directions, major issues, regulatory considerations and trendsetters • Desired: Pharmacy technician, but not required.

🏖️ Benefits

• DailyPay • Flexible Schedules • Competitive Pay with Shift Differentials • Health, Dental, Vision, and Life Insurance • Company-Paid Disability Insurance • Tuition Assistance & Reimbursement • Employee Discount Program • 401k Plan • Paid Time Off • Non-Retail, Closed-Door Environment