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Taunton, MA - 3rd Party Claims Specialist - B&C - 33256

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Taunton, MA - 3rd Party Claims Specialist - B&C - 33256

  • Location:

    Massachusetts

  • Sector:

    MRS Pharmacy

  • Job type:

    Temporary & Contract

  • Salary:

    Negotiable

  • Contact:

    Jessa Amor Carpio

  • Contact email:

    jcarpio@medicalrecruitmentstrategies.com

  • Job ref:

    BBBH394140_1661290992

  • Published:

    about 1 month ago

  • Duration:

    1-12month

  • Expiry date:

    2022-11-21

  • Startdate:

    05/16/2022

  • Client:

    Medical Recruitment Strategies

Job Responsibilities

  • Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to PharMerica and their customers.
  • Research, analyze and appropriately resolve 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.
  • Ensure approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement.
  • Contact providers and/or customers as necessary to obtain additional information needed for claims processing.
  • Monitor and resolve at risk revenue associated with payer set up, billing, rebilling and reversal processes.