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Remote Pharmacy Insurance Jobs in Ohio (NOW HIRING)

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Remote Pharmacy Insurance information

What are the key skills and qualifications needed to thrive as a Remote Pharmacy Insurance Specialist, and why are they important?

To thrive as a Remote Pharmacy Insurance Specialist, you need a strong understanding of pharmacy operations, insurance verification, claims processing, and typically a background in pharmacy tech or healthcare administration. Proficiency with pharmacy management software, insurance portals, and knowledge of HIPAA regulations are crucial, and certification such as CPhT is often preferred. Exceptional attention to detail, problem-solving abilities, and clear communication skills make someone stand out in this position. These skills ensure accurate processing of insurance claims, minimize delays in patient care, and maintain compliance in a remote setting.

What are some common challenges faced when working in a remote pharmacy insurance role, and how can they be managed?

One common challenge in a remote pharmacy insurance role is effectively communicating with both patients and healthcare providers to resolve insurance claims and coverage issues, as much of the work is handled via phone or digital platforms. Additionally, staying updated on frequently changing insurance policies and formularies can be demanding. To manage these challenges, it's helpful to maintain organized digital records, participate in ongoing training sessions, and leverage collaboration tools to stay connected with team members and supervisors. Regular check-ins and open communication channels can ensure that workflow remains smooth and patient needs are promptly addressed.

What is the difference between Remote Pharmacy Insurance vs Remote Pharmacist?

AspectRemote Pharmacy InsuranceRemote Pharmacist
Required CredentialsInsurance licenses, knowledge of pharmacy policiesPharmacy degree, state licensure
Work EnvironmentInsurance companies, customer service, claims processingTelepharmacy, medication review, patient counseling
Industry UsageInsurance and healthcare sectorsHealthcare and pharmacy sectors

Remote Pharmacy Insurance involves managing insurance policies related to pharmacy benefits, focusing on claims and coverage. Remote Pharmacists dispense medications and provide clinical support remotely. While both roles require pharmacy knowledge, one centers on insurance administration, and the other on direct patient care.

What are Remote Pharmacy Insurance jobs?

Remote Pharmacy Insurance jobs involve working with pharmacy benefit management, insurance claims, and patient medication coverage from a remote location. Professionals in these roles often process insurance claims, verify prescription benefits, communicate with healthcare providers and patients, and handle billing issues. These positions may be filled by pharmacy technicians, pharmacists, or insurance specialists and require strong attention to detail, knowledge of pharmacy operations, and excellent communication skills. Remote Pharmacy Insurance jobs allow individuals to perform their duties from home or any location with internet access, making them ideal for those seeking flexible work arrangements.
What are the most commonly searched types of Pharmacy Insurance jobs in Ohio? The most popular types of Pharmacy Insurance jobs in Ohio are:
What are popular job titles related to Remote Pharmacy Insurance jobs in Ohio? For Remote Pharmacy Insurance jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Pharmacy Insurance jobs in Ohio look for? The top searched job categories for Remote Pharmacy Insurance jobs in Ohio are:
What cities in Ohio are hiring for Remote Pharmacy Insurance jobs? Cities in Ohio with the most Remote Pharmacy Insurance job openings:
Remote Pharmacy Insurance jobs near you
Infographic showing various Remote Pharmacy Insurance job openings in Ohio as of July 2026, with employment types broken down into 91% Full Time, 6% Part Time, and 3% Contract. Highlights an 3% In-person, and 97% Remote job distribution.

Pharmacy Billing Manager

Communicarehealth

Broadview Heights, OH • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago

Job description

Job Address:

9299 Market Place Broadview Heights, OH 44147


Pharmacy Billing Manager
Job Type: Full-Time - Remote - Pharmacies: West Virginia, Ohio, Indiana and Maryland
Position Overview:
Manage the day to day operation of the billing unit for each pharmacy. Manage and update patient accounts to ensure consistent billing processes for all payers as outlined in the pharmacy billing manual. Help manage the pharmacy credentialing process for various PBM insurance payers (Med D, Managed Medicaid, commercial, ect.) for each PSG pharmacy location.
Key Responsibilities:

  • Manage the day to day operations of the billing team
  • Ensure that all billing processes are followed as outline in the billing manual to ensure consistency and prescription integrity for compliance
  • Maintain all current patient accounts by verifying, adding or editing current insurance (Medicare Part D, Commercial, Medicaid, Medicare A and Managed Care)
  • Works closely with the facility business office managers for Medicare Part D insurance plans and Census clarifications
  • Works directly with several hospice plans and third party plans as needed.
  • Review the setup of SQL reporting to ensure that all charges are billed appropriate as outlined in the billing manual
  • Manage the pharmacy credentialing process for PBM insurance payers (Medicare Part D, Commercial, Medicaid, Medicare A and Managed Care) for each PSG pharmacy location
  • Ensure all pharmacies are actively credentialed/re-credentialed with PBM insurance payers
  • Any other assigned duties assigned
  • Follow federal and state regulations
  • Adhere to company policies and procedures
  • Follow HIPPA guidelines and regulations

Qualifications:

  • Management of a Team of employees a plus (but not required)
  • Previous Long-Term Care pharmacy experience a plus (but not required)
  • Knowledge of Framework LTC a plus (but not required)
  • Experience in Pharmacy insurance payer credentialing (LTC pharmacy experience preferred)

Salary and Benefits:

  • Competitive salary commensurate with experience
  • Comprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more

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