[Hiring] Reimbursement Specialist II @Navitus Health Solutions, LLC

Role Description

Due to growth, we are adding a Reimbursement Specialist II to our team. Under direction from the Assoc. Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, the Reimbursement Specialist II is primarily responsible for following standard operating procedures to monitor, review and investigate claim submissions and responses. The Reimbursement Specialist II shall have knowledge of billing procedures and work to reduce discrepancies, inaccuracy and outstanding balances. The Reimbursement II shall assist in creating work instructions and training other members of the Reimbursement team.

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Responsibilities

• Responsible for ongoing monitoring of claims activity for accuracy and successful submission
• Responsible for ensuring that patient billing information is set up appropriately in the pharmacy software
• Responds to employee/patient/client questions or complaints regarding reimbursement and/or billing
• Responsible for having knowledge and understanding of complex claims issues to be able to review, resolve and train others how to identify
• Responsible for training other staff on vendor programs and claims discrepancy reports
• Works with internal teams to review and resolve claim issues
• Maintains accurate reference information relating to reimbursement and copay assistance
• Other duties as assigned

Qualifications

• High school diploma or GED
• Some college preferred
• CPhT Preferred
• Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure
• Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing, is preferred
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!

Pay Range

USD $20.19 - USD $23.75 /Hr.