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Insurance Claims Associate Remote Jobs in Kentucky

PharMerica

Claims Specialist / Remote

Louisville, KY · On-site +1

Company-Paid Disability Insurance * Tuition Assistance & Reimbursement * Employee Discount Program ... Associate's or Bachelor's Degree Work Experience: * Required: Customer Service * Desired: Up to one ...

PharMerica

Claims Specialist / Remote

Louisville, KY · Remote

Company-Paid Disability Insurance * Tuition Assistance & Reimbursement * Employee Discount Program ... Associate's or Bachelor's Degree Work Experience: * Required: Customer Service * Desired: Up to one ...

Erie Insurance

Liability Specialist

Lexington, KY · Remote

$63K - $100K/yr

At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a ... Associates or bachelor's degree preferred. Additional Experience * Five years casualty claims ...

PharMerica

Claims Processing Supervisor

Louisville, KY · On-site +1

This is a remote opportunity . Applicants can live anywhere within the Continental USA. Night Shift ... Associate II staff to insure they are adequately communicating staff training needs, shadowing ...

PharMerica

Claims Processing Supervisor

Louisville, KY · Remote

This is a remote opportunity . Applicants can live anywhere within the Continental USA. Night Shift ... Mentor and provide oversight of Team Leads and Associate II staff to insure they are adequately ...

Onco360

Pharmacy Prior Authorization Specialist

Louisville, KY · On-site +1

$18.75 - $24.25/hr

Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial ... Associate degree or Certified Pharmacy Technician (PTCB) * 3+ years of experience in pharmacy or ...

InsCipher

$21 - $26/hr

... insurance, surplus lines associations, and brokers nationwide. We're achieving that goal by ... Remote to join our team. Under the direction of the Filing Services Team Lead this role will be ...

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Insurance Claims Associate Remote information

What does an Insurance Claims Associate do when working remotely?

An Insurance Claims Associate working remotely is responsible for processing and evaluating insurance claims submitted by policyholders. They review documentation, verify claim details, communicate with clients and other stakeholders, and ensure claims comply with company policies and regulations. Remote associates use digital tools to manage claims, handle customer inquiries, and keep accurate records, all while maintaining a high level of confidentiality and customer service. Their goal is to resolve claims efficiently and fairly, either approving payment or denying claims as appropriate.

What is the difference between Insurance Claims Associate Remote vs Insurance Claims Processor?

AspectInsurance Claims Associate RemoteInsurance Claims Processor
CredentialsHigh school diploma or equivalent; some roles may require insurance certificationsHigh school diploma or equivalent; insurance certifications beneficial
Work EnvironmentRemote, home-based settingTypically office-based or remote, depending on employer
Industry UsageCommon in insurance companies, third-party administratorsUsed in insurance companies, claims departments
Job FocusHandling claims inquiries, customer service, initial claim reviewProcessing claims, data entry, verifying information

Both roles involve working with insurance claims, often requiring similar credentials and industry experience. The main difference is that Insurance Claims Associate Remote emphasizes customer interaction and initial claim handling in a remote setting, while Insurance Claims Processor focuses more on data processing and verification, which can be in-office or remote.

What are some of the main challenges faced by remote Insurance Claims Associates, and how can they be overcome?

One of the key challenges for remote Insurance Claims Associates is maintaining effective communication with both clients and internal teams, especially when handling complex claims. Staying organized and using digital collaboration tools can help bridge the gap and ensure timely follow-ups. Additionally, remote associates may need to be proactive in seeking support or clarification on policy details and claim procedures. Regular check-ins with supervisors and participating in virtual training sessions can help address these challenges and foster professional growth in a remote setting.

What are the key skills and qualifications needed to thrive as an Insurance Claims Associate (Remote), and why are they important?

To thrive as an Insurance Claims Associate (Remote), you need strong analytical skills, attention to detail, and a background in insurance or related fields, often supported by a high school diploma or relevant certifications. Familiarity with claims management software, document processing systems, and Microsoft Office Suite is typically required. Exceptional communication, problem-solving abilities, and time management are standout soft skills for remote collaboration and customer service. These skills are crucial to efficiently process claims, ensure accuracy, and deliver a positive experience for policyholders in a virtual work environment.
What are popular job titles related to Insurance Claims Associate Remote jobs in Kentucky? For Insurance Claims Associate Remote jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Associate Remote jobs in Kentucky look for? The top searched job categories for Insurance Claims Associate Remote jobs in Kentucky are:
What cities in Kentucky are hiring for Insurance Claims Associate Remote jobs? Cities in Kentucky with the most Insurance Claims Associate Remote job openings:
Insurance Claims Associate Remote jobs near you
Claims Specialist / Remote

Claims Specialist / Remote

PharMerica

Louisville, KY • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago

PharMerica rating

6.6

Company rating: 6.6 out of 10

Based on 103 frontline employees who took The Breakroom Quiz

56th of 104 rated pharmacies

Job description

Our Company
PharMerica
Overview
Step Into a Rewarding Role as a Claims Specialist with PharMerica!
Are you ready to make a real impact in a growing organization? Join our PharMerica team as a Claims Specialist, where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly matters-delivering exceptional care and service.
Why Join PharMerica?
  • Focused on Service Excellence: Our mission is to provide top-quality care and outstanding customer service to hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers across the nation.
  • Career Growth: We're in high growth mode, offering plenty of opportunities for those looking to advance their careers.
  • Remote Flexibility: This position is 100% remote, giving you the freedom to work from anywhere!

What You'll Do: As a dynamic Claims Specialist, you will:
  • Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need.
  • Be a vital part of a team that's dedicated to enhancing patient care through meticulous claims management and customer service.

Shift: Varying shifts available from 4:30am-12:00am
What We Offer:
  • DailyPay
  • Flexible Schedules
  • Competitive Pay with Shift Differentials
  • Health, Dental, Vision, and Life Insurance
  • Company-Paid Disability Insurance
  • Tuition Assistance & Reimbursement
  • Employee Discount Program
  • 401k Plan
  • Paid Time Off
  • Non-Retail, Closed-Door Environment

Responsibilities
The Claims Specialist - 3rd Party:
  • 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

Qualifications
Education/Learning Experience:
  • Required: High School Diploma or GED
  • Desired: Associate's or Bachelor's Degree

Work Experience:
  • Required: Customer Service
  • Desired: Up to one year of related experience. Pharmacy Technician experience

Skills/Knowledge:
  • 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

Licenses/Certifications:
  • Desired: Pharmacy technician, but not required

About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.
Additional Job Information
This is an excellent opportunity to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.
Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.

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