Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
- Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks
- Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines
- Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
- Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes
- Works as a team to identify, document, communicate and resolve payer/billing trends and issues
- Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans
- Prepares and maintains reports and records for processing
- Performs other tasks as assigned
- Required: High School Diploma or GED
- Desired: Associate’s or Bachelor’s Degree
- Required: Customer Service
- Desired: Up to one year of related experience. Pharmacy Technician experience
- Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office Suite
- Desired: Knowledge of the insurance industry’s trends, directions, major issues, regulatory considerations and trendsetters
- Desired: Pharmacy technician, but not required
About our Line of Business
BrightSpring is the parent company of a family of services and brands that provides clinical, nonclinical, pharmacy and ancillary care services for people of all ages, health and skill levels across home and community settings.
The company is the leading provider of diversified home and community-based health and pharmacy services to medically complex and high-need populations. Its primary businesses include: behavioral health (including autism services), home health care (including personal care, home health, and hospice), neuro therapy, and job placement and vocational training, supported by pharmacy and telecare ancillary technologies and services. These businesses employ over 50,000 dedicated team members in 50 states and provide services for over 350,000 people every day.
BrightSpring. Not just your best career. Your best life.
At BrightSpring, we need excellent people. To do excellent things. Have you wanted to make a difference in the lives of people – or entire communities? At BrightSpring you can.
This in fact could be the amazing opportunity you have been looking for. Have you wanted to find a place where there was no limit to the training you can receive throughout your career? BrightSpring® has it all. Why not find out what we can offer you?
BrightSpring lets you choose the health care field that fits you best.
· HomeCare Services
· Community Living Services
· Family & Youth Services
· Neuro Rehabilitation Services
· Behavioral Health Services
· Telecare & Remote Support
· Pharmacy Services
· Workforce Services
At BrightSpring, we’re putting out the call for everyone from caregivers to nurses to specialists to administrators to business leaders and IT innovators. If you want to be a part of an organization that is shaping the future of American health care, we invite you to take a look at what BrightSpring can offer you…