Top 147 Pharmerica Jobs

Claims Specialist Team Lead
PharMerica —Louisville, KY
- Full-time
- Remote
- Word processing
- Computer literacy
- No high school diploma
- Health insurance
- Dental insurance
7d
Full-time Hospital Pharmacist
PharMerica —New Albany, IN
- Full-time
- Hospital
- Mid-level
- Bachelor's degree
- Disability insurance
- Dental insurance
Lead Pharmacy Technician
PharMerica —Bensenville, IL
- $21 - $24 an hour
- Full-time
- Customer service
- Computer literacy
- Sanitation
- Disability insurance
- Health insurance
1d
Hospital Pharmacist in Charge
PharMerica —Rapid City, SD
- Weekends as needed
- Hospital
- Mid-level
- Bachelor's degree
- Health insurance
- Dental insurance

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Claims Specialist Team Lead

PharMerica -
Louisville, KY

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Job Details

Full-time
7 days ago

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance
Employee discount
Pet insurance

Qualifications

Optimizing workflow processes
Resource allocation
Computer operation
Records maintenance
Staff supervision
Medicare
Variance analysis
Team supervision
Phone communication
Word processing
Computer literacy
Overseeing healthcare denial management
Coaching
Performance feedback (performance evaluation method)
Mid-level
3 years
High school diploma or GED
Quality assurance audits
Analysis skills
Health insurance knowledge
Medicare regulations
Continuous improvement
Team training
Medical denial root cause analysis (RCA)
Mentoring
AS400
Organizational skills
Centers for Medicare & Medicaid Services (CMS) billing regulations
Managing insurance claims teams
Management reporting

Full Job Description

Our Company:

PharMerica

Overview:

PharMerica, a part of Brightspring Health Services, is a long‑term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States.

The 3rd Party Claims Specialist Team Lead is a subject matter expert (SME) on the company’s denial research methods, internal and external databases, reporting tools and policies and procedures. The Team Lead is a SME on all types of denials and functions performed by both the Claims Specialist I and Claims Specialist II and acts as a trainer and mentor to both.

Shift: Multiple Shifts Available

Remote position

Benefits and perks for You!

Medical, Dental, Vision insurance
Health Savings & Flexible Spending Accounts (up to $5,000 for childcare)
Tuition discounts & reimbursement
401(k)
Company Paid Time Off*
Shift Differential
DailyPay
Pet Insurance
Employee wellness and discount programs

Benefits may vary by employment status

Responsibilities:

Trains new employees and ensures all applicable training materials are provided and reviewed
Provides support to staff and acts as a mentor/coach to promote a positive environment
Provides feedback on all levels of staff to supervisor to be used in employees one on ones, check-ups and reviews
Identifies staff performance issues and discuss with Supervisor
Provides the necessary re-training or one on one support with staff to assist in meeting the performance expectations
Assists management with fair distribution of work/site assignments being sure to communicate when the workloads are off balance and make suggestions on how to reconcile
Reviews variances and write-offs submitted by staff for accuracy of information and approval requirements before giving to Supervisor for approval
Performs monthly quality assessments on staff to ensure accuracy. Report any identified training needs to Supervisor and Manager for further review and follow-up action plan as needed
Prepares and maintain reports and records for processing as well as run and produce miscellaneous reports as assigned or necessary
Identifies potential financial exposure and risk to the company with underperforming or non-compliant payers
Stays up to date on third-party billing requirements
Monitors and provide support to those assigned to work convert billing exception reports to ensure claims are billed to accurate financial plans timely
Completes billing transactions for non standard order entry situations as required
Provides education to management and team members on payer specific claim processing rules, reimbursement, and other policy guidelines as gleaned by, and confirmed through working directly with payers
Takes initiative to find opportunities and make suggestions for process improvement within the department

Qualifications:

EDUCATION/EXPERIENCE

High School graduate, GED or equivalent experience.
Desired: Associates degree, 4 year college or technical degree.
3+ years insurance billing experience.
Specialized understanding of billing requirements in one of the following areas: Medicare Part D, Medicaid, and Commercial billing.
Understanding of revenue cycle functions within pharmacy practice or equivalent setting.

LICENSE/CERTIFICATION/OTHER SPECIAL REQUIREMENTS

Desired: Pharmacy Technician.

KNOWLEDGE/SKILLS/ABILITIES

Strong analytical skills, excellent time management and attention to details.
Working knowledge in MS Office Products (Excel, Word) and basic computer knowledge.
Comfortable making phone calls and interacting with internal/external entities.
AS400, Frameworks or QS1, Computer Systems Experience.
Communication, problem solving, detail oriented and teamwork, customer service, and accuracy.
Strong organization skills, self-starter, and confidence.
Must be a positive mentor to all staff.

*This position will require sitting, standing, and walking. It will also require frequent typing on a keyboard. Ability to push/pull 21-30 lbs, and carry up to 21-30 lbs.*

About our Line of Business: PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.

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Claims Specialist Team Lead

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Hospital Pharmacist in Charge

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