What are the responsibilities and job description for the PHARMACY CLAIMS SPECIALIST - FULL TIME position at JFK Johnson Rehabilitation Institute?
Pharmacy Claims Specialist - Full Time
POST-ACUTE CARE PHARMACY Borough of Eatontown, New Jersey
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Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
Responsible for long-term care pharmacy third party billing functions as assigned by the Billing Manager. Works alongside the pharmacy operations team to ensure timely submission and resolution of prescription claims.
Responsibilities
A day in the life of a Pharmacy Claims Specialist at Hackensack Meridian Health includes:
Education, Knowledge, Skills and Abilities Required:
HACKENSACK MERIDIAN HEALTH (HMH) IS AN EQUAL OPPORTUNITY EMPLOYER
All qualified applicants will receive consideration for employment without regard to age, race, color, creed, religion, sex, sexual orientation, gender identity or expression, pregnancy, breastfeeding, genetic information, refusal to submit to a genetic test or make available to an employer the results of a genetic test, atypical hereditary cellular or blood trait, national origin, nationality, ancestry, disability, marital status, liability for military service, or status as a protected veteran.
Our Network
Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility
As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.
Apply
Share
See the area you’ll be working in and get an idea of what your daily routine around the office can be like. Learn More
Awards We’ve Received
2023
US News & World Report 2023
US News & World Report 2023
US News & World Report 2023
2023
2023 & 2022 Magnet Designations
for 9 HMH Institutions
2022
Newsweek 2022 Best Hospitals USA
Newsweek 2022 America’s Best Addiction Treatment Centers
Blake Recovery Center at Carrier Clinic - #2
2023
Diversity Inc. 2023
Top Hospital and Health Systems
2022
Becker’s Hospital Review 2022
At Hackensack Meridian Health, we help our patients live better, healthier lives – and we help one another succeed. Here, competitive benefits are just the beginning. It’s also about how our team members support one another and how we show up for our community. Together, we’re ready to transform health care and advance our mission to serve as a leader of positive change.
Join us and let’s keep getting better together.
STAY CONNECTED
From roles that are right for you to new opportunities, join our talent community and stay up to date with job openings and more.
SIGN UP
POST-ACUTE CARE PHARMACY Borough of Eatontown, New Jersey
Apply
- Requisition # 2025-158781
- ShiftDay
- StatusFull Time with Benefits
Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
Responsible for long-term care pharmacy third party billing functions as assigned by the Billing Manager. Works alongside the pharmacy operations team to ensure timely submission and resolution of prescription claims.
Responsibilities
A day in the life of a Pharmacy Claims Specialist at Hackensack Meridian Health includes:
- Submit daily prescription batches for payment by third party payers.
- Research and establish patient eligibility coverage with prescription insurance providers.
- Maintain and update patient billing and prescription insurance information.
- Troubleshoot rejected insurance claims resulting in payments.
- Interact with the prescription insurance companies on a daily basis regarding overrides, rejections, and insurance updates.
- Follow-up on and resolve pending billing issues.
- Process daily rejected prescription claims.
- Research and submit unit-dose billing rejected claims on a weekly basis.
- Submit, track, and follow-up on prior authorizations.
- Assist with Customer Pre-Admission Price Quotes.
- Check Medicaid eligibility on Medicaid Pending LTC residents and rebill claims
- Other duties as assigned.
Education, Knowledge, Skills and Abilities Required:
- High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
- Minimum of one (1) year of experience as a pharmacy tech in a retail/long-term care pharmacy setting.
- Excellent customer service and phone skills.
- Associate's degree.
- Long-term care billing department experience.
- Framework LTC experience.
- GSuite (Docs, Sheets, and Gmail).
- Pharmacy Technician License.
HACKENSACK MERIDIAN HEALTH (HMH) IS AN EQUAL OPPORTUNITY EMPLOYER
All qualified applicants will receive consideration for employment without regard to age, race, color, creed, religion, sex, sexual orientation, gender identity or expression, pregnancy, breastfeeding, genetic information, refusal to submit to a genetic test or make available to an employer the results of a genetic test, atypical hereditary cellular or blood trait, national origin, nationality, ancestry, disability, marital status, liability for military service, or status as a protected veteran.
Our Network
Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility
As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.
Apply
Share
- X
- LinkedIn
See the area you’ll be working in and get an idea of what your daily routine around the office can be like. Learn More
Awards We’ve Received
2023
US News & World Report 2023
- HUMC - #1 Hospital in NJ & #5 in NY Metro Area
US News & World Report 2023
- Joseph M. Sanzari Children’s Hospital - #1 Children’s Hospital in NJ
US News & World Report 2023
- JSUMC - #6 Hospital in NJ
2023
2023 & 2022 Magnet Designations
for 9 HMH Institutions
2022
Newsweek 2022 Best Hospitals USA
- HUMC - #57
Newsweek 2022 America’s Best Addiction Treatment Centers
Blake Recovery Center at Carrier Clinic - #2
2023
Diversity Inc. 2023
Top Hospital and Health Systems
2022
Becker’s Hospital Review 2022
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At Hackensack Meridian Health, we help our patients live better, healthier lives – and we help one another succeed. Here, competitive benefits are just the beginning. It’s also about how our team members support one another and how we show up for our community. Together, we’re ready to transform health care and advance our mission to serve as a leader of positive change.
Join us and let’s keep getting better together.
STAY CONNECTED
From roles that are right for you to new opportunities, join our talent community and stay up to date with job openings and more.
SIGN UP
