Reimbursement Specialist II

This is a Fully Remote Job About Our Client:This organization operates within the specialty pharmacy services sector, focusing on managing and optimizing reimbursement processes for pharmacy claims. It addresses challenges related to billing accuracy, claim discrepancies, and outstanding balances by implementing monitoring and review procedures to ensure successful claim submissions and accurate patient billing. About the Opportunity:The REIMBURSEMENT SPECIALIST II plays a crucial role in maintaining the integrity and accuracy of pharmacy claims submissions. This position is responsible for monitoring claims activity, resolving complex claim issues, and training team members to uphold high standards in reimbursement processes. The role supports efficient billing operations and contributes to reducing claim errors and financial discrepancies. Responsibilities:Monitor claims activity for accuracy and successful submissionEnsure patient billing information is correctly set up in pharmacy softwareAddress questions or complaints related to reimbursement and billingReview and resolve complex claims issuesTrain staff on vendor programs and claims discrepancy reportsCollaborate with internal teams to resolve claim issuesMaintain accurate reimbursement and copay assistance reference informationPerform other duties as assigned Requirements:High school diploma or GEDSome college education preferredCPhT preferredPharmacy technician or trainee license strongly preferred in applicable statesExperience with pharmacy, health plan, or clinical insurance claims billing preferredCommitment to compliance program objectivesAbility to interact cooperatively and respectfully with employees Pay Range and Compensation Package:USD 20.19 - USD 23.75 per hour Benefits & Perks:Health, Dental, and Vision insurance20 days paid time off4 weeks paid parental leave9 paid holidays401(k) company match up to 5% with no vesting requirementAdoption Assistance ProgramFlexible Spending AccountEducational Assistance Plan and Professional Membership assistanceReferral Bonus Program up to $750 Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.