Pharmacy Claims Representative 2 - Patient Financial Services

Become a part of our caring community The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Use your business knowledge to help analyze data and provide financial support. Humana is seeking a Patient Finance Specialist that will work on the behalf of CenterWell Specialty Pharmacy customers, develop relationships with foundations and manufacturers, and provide internal customer support for the entire Pharmacy. Location: Remote Arizona or Ohio only Shift: Must be able to work an 8 hour shift between 8am and 8pm EST Monday-Friday. Overtime may be required during peak season. The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. Patient Finance Specialist detailed description: Source Patient Assistance programs and/or foundations to assist patient