Claims Resolution Specialist - Remote

Overview

The Claims Resolution Specialist will provide direct and high-quality assistance to patients, prescribers, and pharmacies, diagnosing and resolving barriers to medication access for patients of health center clients.

In Short

• Assist in insurance billing and prior authorizations.
• Receive referrals via email, phone, and electronic messaging.
• Communicate with pharmacies and insurance plans to resolve issues.
• Utilize the CoverMyMeds platform for submissions.
• Document and follow up on referral outcomes.
• Work independently and manage time effectively.
• Maintain confidentiality of client information.
• Preferred experience in healthcare settings.
• Excellent verbal communication skills are essential.
• Must be able to multitask and prioritize efficiently.

Requirements

• Associate College Degree or higher / Minimum High School diploma.
• 3-4 years of previous pharmacy technician or claims insurance experience.
• Ability to work under leadership direction.
• Self-motivated and able to work independently.
• Ability to use personal computers and software applications.
• Strong time management skills.
• Ability to establish cooperative working relationships.
• Ability to report work orally or in writing.
• Experience in a healthcare setting is preferred.
• Knowledge of the healthcare industry is a plus.

Benefits

• Equal employment opportunities for all employees.
• Supportive work environment.
• Opportunities for professional growth.
• Work-life balance with remote work options.
• Comprehensive training provided.