Step into a meaningful healthcare role as a Pharmacy Claims Specialist with PharMerica, where your work directly supports long-term care and senior living clients. As a Pharmacy Claims Specialist, you’ll manage pharmacy claims, ensure accurate reimbursements, and help patients receive the medication support they need. This fully remote position allows you to make a real impact from anywhere in the Continental USA while joining a supportive, fast-growing team.
Pharmacy Claims Specialist Responsibilities
As a Pharmacy Claims Specialist, you will manage and resolve rejected pharmacy claims, ensuring timely billing and maximum reimbursement. You’ll work with national Medicare D plans, third-party insurance, and state Medicaid programs to identify trends, resolve issues, and maintain accurate records.
Claims Management & Reimbursement
You’ll research, analyze, and correct rejected claims through edits, reversals, and documentation to safeguard revenue. Monitoring at-risk claims and converting billing exception reports will help ensure proper reimbursement and compliance.
Collaboration & Team Support
Work closely with team members to identify payer/billing trends, resolve issues efficiently, and maintain open communication with internal departments. You’ll also assist in preparing reports and records for ongoing claims tracking.
Qualifications & Skills
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High School Diploma or GED required; Associate’s/Bachelor’s degree preferred
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Pharmacy Technician experience is desired but not required
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Strong customer service and communication skills
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Ability to handle multiple tasks in a fast-paced environment
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Familiarity with Microsoft Office and basic math aptitude
Work Environment & Benefits
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Fully remote position (Continental USA)
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Schedule: Monday–Friday, 9 AM–5 PM EST
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Competitive hourly pay: $19–$25/hour
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DailyPay, 401(k), tuition assistance, PTO, health/dental/vision/life insurance
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Non-retail, closed-door pharmacy environment
Why PharMerica?
PharMerica is a leader in long-term care pharmacy, providing value beyond medication. We offer a supportive, growth-oriented environment with opportunities to advance your career. This role is ideal for individuals looking to transition from retail to office-based pharmacy work while gaining expertise in claims, billing, and insurance processing.