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Rx Relief

Pharmacy Specialist

Career Insights for Medical Claims Processor / Representative

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Based on Florida data

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$41,153 / year median in Florida

-3% projected decline

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Job Description

Pharmacy Specialist Rx Relief - 4.1 Fort Lauderdale, FL Job Details Full-time From $20 an hour 5 hours ago Benefits Health insurance Dental insurance Vision insurance Qualifications Appeals Accounts receivable management Medical software Phone communication Insurance dispute resolution Spreadsheets Analysis skills Attention to detail Data interpretation Medical explanation of benefits reviews Medical claims submission Insurance provider collaboration Medical debt collection accounts Collections account management Client interaction via phone calls
Full Job Description Job Title:
Reimbursement Specialist Employer:
Rx relief
Location:
Fort Lauderdale, FL area
Pay Rate:
$20.00 / hour
Schedule:
Monday - Friday, 8:30 AM - 5:30 PM Rx relief is seeking multiple dedicated Reimbursement Specialists to support our expanding healthcare operations near Fort Lauderdale, FL. This position is ideal for revenue cycle professionals who excel at navigating insurance workflows, resolving complex claim disputes, and securing accurate reimbursement. Core Responsibilities Manage full-cycle billing and collections for pharmacy claims, specializing in Workers' Compensation and Personal Injury cases. Analyze aging reports to identify delinquent or underpaid accounts and initiate timely payment recovery. Investigate claim denials and payment adjustments to determine root causes and secure proper funding. Compile necessary clinical files and medical documentation to construct effective formal appeals. Audit claims for errors, correcting patient demographics, CPT codes, and ICD-10 diagnosis codes prior to resubmission. Liaise with insurance carriers, legal representatives, and clinical personnel to resolve open accounts. Maintain organized account records and assist with specialized billing projects as needed. Qualifications & Requirements Minimum of 2 years of hands-on medical billing and collections experience (Workers' Comp background strongly preferred). Working knowledge of insurance claims processing, EOB evaluation, CPT/ICD-10 coding, and denial resolution. Proficiency with Microsoft Excel and medical billing software. Strong analytical, investigative, and problem-solving skills with high attention to detail. Excellent written and verbal communication skills with professional phone etiquette. Ability to work independently while contributing effectively to a fast-paced team environment. Apply today!
RXT2IND1
Pay:
From $20.00 per hour
Benefits:
Dental insurance Health insurance Vision insurance
Work Location:
In person