Pharmacy Claims Representative 2

Job Title: Pharmacy Claims Representative
Location: Remote
Duration: 4 Months (approx.) ***Potential to Extend and/or Convert to FTE; However, Not Guaranteed***
Schedule: 8am-4:30pm EST

Must be licensed as a pharmacy technician in their state of residence
Must be eligible to work with Medicare/Medicaid
National Certification

• The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial.
• Decisions are typically focus on interpretation of area/department policy and methods for completing assignments.
• Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.
• Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.