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Reimbursement Specialist I
Navitus Health Solutions. Follow standard operating procedures to obtain and process manufacturer copay assistance program reimbursement .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in processing manufacturer copay assistance program reimbursements and managing pharmacy billing information. Proficient in compliance with federal and state laws while effectively resolving claims issues and maintaining accurate documentation.
Highest-signal resume keywords
Pharmacy Technician LicenseClaims Billing ExperienceReimbursement ProcessingCompliance Program AdherencePatient Interaction
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims DocumentationBenefit AssessmentsClaims AuditingPharmacy Software ProficiencyReimbursement Monitoring
Soft Skills
Cooperative InteractionRespectful Communication
Certifications & Qualifications
CPhT CertificationPharmacy Technician Trainee License
Industry Keywords
Copay Assistance ProgramsPharmacy BillingHealth Plan ClaimsFederal and State CompliancePatient Profiles
About the role
Key responsibilities & impact- Follow standard operating procedures to obtain and process manufacturer copay assistance program reimbursement
- Monitor claims activity for accuracy and successful submission
- Ensure patient billing information is set up appropriately in pharmacy software
- Participate in conferences and meetings related to reimbursement/billing
- Respond to employee, patient, and client questions or complaints regarding reimbursement and/or billing
- Work with internal teams to review and resolve claim issues
- Maintain accurate reference information relating to reimbursement and copay assistance
- Document information, insurance, and prescriptions/orders accurately and thoroughly within patient profiles
- Comply with applicable federal and state laws and ethical standards
- Perform other duties as assigned
Requirements
What you’ll need- High School Diploma or equivalent GED
- Some college preferred
- CPhT preferred
- Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure
- Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
Benefits
Comp & perks- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!