Banner Default Image

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

Back to job search

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

  • Location:


  • Sector:

    MRS Pharmacy

  • Job type:

    Temporary & Contract

  • Salary:


  • Contact:

    Jessa Amor Carpio

  • Contact email:

  • Job ref:


  • Published:

    about 1 month ago

  • Duration:


  • Expiry date:


  • Startdate:


  • 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.