Pharmacy Claims Specialist Position Available In Clay, Missouri

Pharmacy Claims Specialist Outcomes Operating Inc – 2.4

Kansas City, MO Job Details Estimated:

$39.4K – $48.4K a year 1 day ago Benefits Wellness program Paid parental leave Health savings account Paid holidays Dental insurance Flexible spending account Paid time off Adoption assistance Parental leave Vision insurance 401(k) matching Qualifications Mid-level Microsoft Office 3 years High school diploma or GED Accounting Leadership Time management Full Job Description

JOB SUMMARY

(added February 2024) The Client Account Representative II is responsible for providing exceptional support to our clients who participate in the ReconRx reconciliation program. They interact with clients, payors, and data feed providers via email, messaging application (clients only), and phone. They are responsible for resolving clients’ outstanding claims and maintaining detailed documentation of all actions taken. This individual routinely reviews and deciphers claims data as well as guides clients through various general accounting related reports. The Client Account Representative works with the payors to ensure timely 835 file setups and requests missing 835 files as needed. They also regularly explain adjustments found on the 835 files to their assigned clients. The Client Account Representative II possess a strong understanding of the reconciliation service and escalates more complex inquiries.

ESSENTIAL DUTIES & RESPONSIBILITIES

Assist customers with any program or service needs. Escalate any programming issues to the appropriate team. Create and cultivate relationships with clients. Scheduling and distribution of information for webinars, phone conferences, etc. with customers. Ability to identify common issues across multiple customers and in turn, notify leadership so a solution can be found

KNOWLEDGE & REQUIREMENTS

General understanding of 835 files, pharmacy claim adjudication process, accounts receivable and reconciliation Working knowledge of MS Office Suite Ability to multi-task in a fast-paced environment Detail-oriented and dedicated to follow through Ability to establish a strong rapport with clients Effective time management skills Ability to work well both independently and as a team member

EDUCATION & EXPERIENCE REQUIREMENTS

Minimum years of work experience: 3 years Retail pharmacy and/or accounting experience preferred Minimum level of education or education/experience: High School Diploma

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Frequent sitting in stationary position at a desk Occasional standing, walking, stooping, kneeling, squatting, and climbing stairs Occasional twisting of body Occasional reaching by extending hands and arms in any direction Occasional lifting, pulling, or pushing What’s In It For You? Medical, Dental and Vision Plans Voluntary Benefits

HSA & FSA

Fertility & Family Planning Benefits Paid Parental Leave Adoption Assistance Program Employee Resource Groups Flex PTO for Exempt Associates & up to 15 PTO days in first year of employment for non-exempt associates 11 Paid Holidays Corporate Wellness Program 401k Employer Match & Roth Option Available – immediate eligibility #LI-FC1 #LI-Hybrid