Insurance Claims Manager Jobs in Remote, OR (NOW HIRING)

SUMMARY  

The Certified Pharmacy Technician supports the daily operations of the pharmacy by assisting pharmacists in preparing and dispensing medications, maintaining accurate records, and providing high-quality customer service. This role works collaboratively with pharmacists, healthcare providers, and patients to support optimal patient care 

PRINCIPAL ACTIVITIES & RESPONSIBILITIES

• Assists pharmacists in preparing, compounding, packaging, and labeling medications accurately and efficiently.
• Receives and processes prescription orders, ensuring completeness and accuracy. 
• Enters prescription and patient information into pharmacy systems with a high level of accuracy. 
• Processes insurance claims and assists in resolving claim rejections or billing issues. 
• Maintains and updates patient profiles, including insurance and medication history. 
• Provides customer service to patients, including answering questions, processing payments, and directing clinical inquiries to the pharmacist. 
• Manages inventory, including ordering, receiving, stocking, and removing expired medications. 
• Maintains proper storage and security of medications, including controlled substances. 
• Assists with prior authorizations and coordination with providers and insurance companies. 
• Ensures compliance with HIPAA and all applicable pharmacy laws, regulations, and policies.
• Performs medication reconciliation and supports medication adherence initiatives as directed. 
• Maintains cleanliness and organization of the pharmacy workspace. 
• Collaborates with pharmacists and other healthcare staff to support patient care and workflow efficiency. 
• Assists with audits, documentation, and reporting as required. 
• Participates in ongoing training and continuing education as required. 
• Other duties as assigned. 

LEVEL OF AUTHORITY & RESTRICTIONS

• This position requires working independently without overseeing others, with no authority in decision-making.

PHYSICAL & MENTAL DEMANDS

• Requires the ability to manage moderate levels of stress arising from schedules, workload, diverse or adversarial stakeholders, etc. 
• Must be able to walk, talk, hear, use hands to handle, feel or operate objects, tools, or controls, and reach with hands and arms. 
• Vision abilities required by this job include close vision and the ability to adjust focus. 
• May be required to push, pull, lift, and/or carry up to 50 pounds. 
• Must be able to stand, walk, reach with hands and arms, and climb or balance.

WORKING CONDITIONS & ENVIRONMENT

• Regularly exposed to moving mechanical parts.
• Frequent exposure to outpatients who may be experiencing a wide range of acute and chronic medical conditions. 
• Fast-paced environment with frequent interruptions and competing priorities.
• The noise level in the work environment is usually moderate.

MINIMUM JOB REQUIREMENTS

• Must be 18 years of age or older.
• High School Diploma or equivalent.
• Minimum of three (3) years of pharmacy experience preferred. 
• Current certification as a Pharmacy Technician.
• Active Pharmacy Technician registration/licensure in the State of Oregon.  
• Basic knowledge of pharmacy operations, medication terminology, and dosage calculations. 
• Experience with pharmacy management systems and electronic health records (EHR).
• Experience and proficiency in the use of Microsoft products (Excel, Outlook, PowerPoint, Word, etc).
• Strong organizational, time management, and multitasking skills.
• Excellent communication and customer service skills. 
• Ability to maintain confidentiality and comply with HIPAA requirements. 
• Ability to communicate clearly and effectively in English, verbally, in writing or by other acceptable means. 
• This position is considered a covered role. A state criminal background check and fingerprint-based background check will be required as a condition of employment.
• This position is designated as safety-sensitive and is subject to pre-employment and other authorized drug and alcohol testing in accordance with company policy. Please note that the use of marijuana is prohibited for employees in this position, regardless of state legalization status.
• Must have employment eligibility in the U.S.
• Indian preference will be observed in the hiring process.