Billing Specialist I (Pharmacy Insurance)

Adecco is currently assisting?a?National Pharmaceutical client, recruiting for an Billing Specialist (Pharmacy Insurance) in Woonsocket, RI.?This role works Full-Time Mon - Fri 8:30am - 5pm.
The wage for this position is between $19.33 and $21.20. Hourly wage may depend upon experience, education, geographic location and other factors.
As a Pharmacy Insurance Specialist, you will be responsible for ensuring that all required third party insurance settings are coded and maintained appropriately within the pharmacy adjudication system. The Pharmacy Insurance Specialist will perform extensive testing and documentation to ensure accurate prescription claims processing while remaining in compliance with pharmacy standards and payer requirements. As a part of the Network Operations team, this role allows you to analyze third party programs, and investigate and resolve systemic issues relative to prescription claims processing that interfaces with stores, providers, patients, pricing and financial impacts to the company.

Duties:

• Receiving third party program contract updates and creating or modifying third party plan configurations necessary to comply with industry standards, contract agreements and state and federal regulations
• Working with Pharmacy Application Development teams in Information Systems (IS) to provide prescription claims processing support for all system related issues or enhancements including defining business scenarios and testing procedures, analyzing production issues for any potential causes and recreating all known defects in test environments to assist development
• Working cross-functionally within the department to provide quality assurance within Pharmacy Operations by executing various scenarios affecting data quality, prescription claim processing and providing in-depth analysis of the results

What we need from you :

• 1+ year related experience in a pharmacy, PBM, or insurance position
• 1+ years of experience using Microsoft Word and Excel
Preferred Qualifications :

• Pharmacy Technician Experience
• Previous experience with business-to-business, interdepartmental, or customer interactions
• Retail Pharmacy help desk experience
• Experience with SQL or Access

Click on apply now for instant consideration!

This employer requires all employees, temporary labor, consultants, and contractors to be fully vaccinated against COVID-19 by their start date, subject to approved medical or religious exemptions.
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Equal Opportunity Employer/Veterans/Disabled

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The Company will consider qualified applicants with arrest and conviction records