Pharmacy Claims Processor

Job not on LinkedIn

🔥 14 hours 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%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 approvals 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

🎯 Requirements

• High School Diploma or GED • Customer Service experience • Must have pharmacy claims or adjudication background • 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 is desired • Knowledge of the insurance industry’s trends, directions, major issues, regulatory considerations and trendsetters is desired • Pharmacy technician certification is desired 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 • 100% remote work