Pharmacy Claims Processor

Job not on LinkedIn

🔥 0 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

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Okta

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 2010

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

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

• Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing • Research, analyze, and resolve rejected claims involving Medicare D plans, third-party insurance companies, and state Medicaid plans • Perform edits and/or reversals to obtain claim approval and maximize payer reimbursement • Monitor and resolve at-risk revenue associated with payer setup, billing, rebilling, and reversal processes • Identify, document, communicate, and resolve payer and billing trends and issues as part of a team • Review and convert billing exception reports to ensure claims are billed to accurate financial plans • Prepare and maintain processing reports and records • Perform other assigned tasks • Support pharmaceutical care and customer service for long-term care and senior living clients

🎯 Requirements

• High School Diploma or GED • Customer Service experience • 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 • Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference • Associate’s or Bachelor’s Degree desired • Up to one year of related experience desired • Pharmacy technician certification desired but not required • Ability to work nights and weekends

🏖️ 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 • 100% remote work flexibility