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Our CompanyPharMerica OverviewJoin our PharMerica team! PharMerica is aclosed-door pharmacywhere you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh growth mode, which meansadvancement opportunitiesfor individuals who are looking for career progression! We offer: DailyPay Flexible schedules Competitive pay Shift differential Health, dental, vision and life insurance benefits Company paid STD and LTD Tuition Assistance Employee Discount Program 401k Paid-time off Tuition reimbursement Non-retail/Closed-door environment Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today! Responsibilities
Act as a resource to the facilities in obtaining information completing necessary documentation or following up on outstanding claims
Individual with an understanding of Insurance and Medicaid formularies and processes including the prior authorization processes
Makes outgoing calls to Facilities, Plans, and Physician’s offices as needed to obtain approvals
Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to effectively communicate and resolve customer issues
Performs other tasks as assigned
Achieves productivity goals with regard to calls/claims per hour as determined by the Director and Clinical Hub Manager
Provide clinical support to members of the RxAllow team regarding prior authorization concerns / submissions
Conducts job responsibilities in accordance with the standards set out in the Company’s code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and State Laws, and applicable professional standards
Familiar with the claim adjudication process
Develop a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow
Qualifications
High School Diploma, Associates degree; Bachelor's degree preferred
Certified Pharmacy Technician or Medical Assistant Certification desired
Third party Medical Billing experience
EMAR system knowledge
One to three years of pharmacy experience preferred
Three years of call center experience preferred
Understanding of insurance and medicaid formularies and processes including the prior authorization processes
Familiar with the claim adjudication process
Proficiency in Microsoft Office programs
Prioritize work to meet daily and competing deadlines
About our Line of BusinessPharMerica is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica is one of the nation's largest pharmacy companies. PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about PharMerica, please visit www.pharmerica.com. Follow us on Facebook (https://www.facebook.com/PharMericaCorp/) , Twitter (https://twitter.com/PharMericaCorp/) , andLinkedIn (https://www.linkedin.com/company/pharmerica/) .Need help finding the right job?We can recommend jobs specifically for you!ALERT: We are aware of a scam whereby imposters are posing as employees from our company. Beware of anyone requesting financial or personal information. We take pride in creating a best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, driver’s license, bank information, or payment for work equipment, etc.) from you via text or email. If you are suspicious of a job posting or job-related email mentioning our company, please contact us at TalentAcquisition@brightspringhealth.com . Click here (https://www.brightspringhealth.com/careers/frequently-asked-questions/) for additional FAQ information. Job LocationsUS-TX-ARLINGTONID 2023-129251 Line of Business PharMerica Position Type Full-Time
