Workers Compensation Reimbursement Specialist Position Available In Duval, Florida
Tallo's Job Summary: InjuryScripts in Jacksonville, FL is seeking a Workers' Compensation Reimbursement Specialist to manage pharmacy claims, appeals, and collections for injured individuals. The role involves ensuring timely reimbursement from insurance carriers, third-party administrators, and legal representatives. Candidates with 2+ years of related experience are preferred, along with strong communication skills and a focus on compliance with state regulations.
Job Description
Workers’ Compensation Reimbursement Specialist InjuryScripts Jacksonville, FL •
Remote Description:
At InjuryScripts, we specialize in providing pharmacy services to injured individuals, with a focus on those covered under workers’ compensation and auto accident claims. Our mission is to ensure timely and accurate reimbursement while navigating complex state and carrier regulations. We’re looking for a skilled and driven Reimbursement Specialist to join our growing team and help us streamline the reimbursement and collections process.
Job Description:
We are seeking an experienced Reimbursement Specialist to manage the submission, tracking, and appeals process for pharmacy claims related to workers’ compensation and auto accident cases . This role plays a vital part in ensuring the pharmacy receives proper and timely reimbursement from insurance carriers, third-party administrators, and legal representatives. This position offers flexible work arrangements – it can be fully remote, hybrid, or in-person , depending on the candidate’s location and preference.
Key Responsibilities:
Submit and track pharmacy claims for workers’ compensation and auto accident/PIP/MedPay patients. Investigate and appeal denied claims, ensuring documentation and follow-ups align with state laws and carrier-specific protocols. Communicate with insurance adjusters, attorneys, third-party administrators, and internal pharmacy staff to resolve claim and reimbursement issues. Stay current on state-specific regulations , fee schedules, and policy changes that impact reimbursement for injury-related claims. Develop and improve internal collections workflows , tracking systems, and reporting tools. Analyze denial trends and unpaid claims to drive recovery efforts and prevent future issues. Educate internal staff on best practices for documentation, claims submission, and appeals for injury-based billing.
Requirements:
Required:
2+ years of experience in pharmacy reimbursement related to workers’ compensation and/or auto accident claims (PIP/MedPay) . Strong understanding of carrier reimbursement processes, appeal strategies, and state regulations. Demonstrated success in managing denied claims and collections. Experience with pharmacy billing platforms, clearinghouses, and claim tracking tools.
Preferred:
Background in an injury-focused or independent pharmacy. Familiarity with WCEDI, Jopari, or similar eBilling systems. Understanding of auto accident legal processes.
Skills & Competencies:
Strong verbal and written communication skills. High attention to detail and strong follow-up discipline. Analytical thinking with ability to identify patterns and optimize processes. Ability to work independently while staying aligned with team goals and deadlines.
