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Remote Pharmacy Insurance Jobs in Puerto Rico (NOW HIRING)

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site +1

Remote/hybrid experience preferred * A minimum of 2-4 years' administrative experience and/or ... Knowledge in pre-authorizations and health insurance client services departments are preferred

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site

Remote/hybrid experience preferred * A minimum of 2-4 years' administrative experience and/or ... Knowledge in pre-authorizations and health insurance client services departments are preferred

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site

Remote/hybrid experience preferred * A minimum of 2-4 years' administrative experience and/or ... Knowledge in pre-authorizations and health insurance client services departments are preferred

All JobsRemote Pharmacy Insurance JobsRemote Pharmacy Insurance Jobs in Puerto Rico

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 popular job titles related to Remote Pharmacy Insurance jobs in Puerto Rico? For Remote Pharmacy Insurance jobs in Puerto Rico, the most frequently searched job titles are:
What job categories do people searching Remote Pharmacy Insurance jobs in Puerto Rico look for? The top searched job categories for Remote Pharmacy Insurance jobs in Puerto Rico are:
Remote Pharmacy Insurance jobs near you

Senior Billing Specialist (Remote)

Capitol Bridge, LLC

PR • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Senior Billing Specialist (Remote)

Capitol Bridge is currently seeking a candidate for a full-time Senior Billing Specialist role. This role will be a significant addition to the accounting team with responsibilities for complex government invoicing and accounting practices. Prepare invoices for all types of Government contracts, research and resolve billing discrepancies to ensure invoice accuracy and completeness, work closely with customers, payroll, and contracts departments to resolve any invoicing and collection issues, while collaborating with the Controller and the accounting team on AR Aging, billing, and balance sheet reconciliations. This position requires an individual to thrive and lead in a fast-paced environment where workflows change and move rapidly, forcing you to quickly adapt to new circumstances or juggle multiple daily tasks and deadlines.

Responsibilities:
  • Ownership of the full-cycle invoicing process to ensure timely and accurate customer billings and collections.
  • Work with project staff to ensure that bills go forward as quickly as possible, following up on needed approvals to finalize bills.
  • Review and analyze Job Cost Reports for invoice validation and research discrepancies.
  • Establish procedures, routines, and related documentation regarding billing and contract maintenance.
  • Identify and research invoicing issues, including customer rejections and short paid invoices, and provide guidance and resolution, as appropriate.
  • Assist in managing the collection of customer invoices, including contacting customers to resolve delays in invoices and payment processing.
  • Analyze and reconcile receivables and unapplied receipts monthly and ensure timely resolution.
  • Assists in implementing processes and procedures that will improve efficiency and strengthen internal controls.
  • Excellent customer service skills, positive attitude, attention to detail, accountability to complete work assigned independently with urgency, and the ability to balance multiple tasks.
  • Support internal & external audits related to the A/R function and other functions as needed.
  • Support the Controller and the accounting team with month end activities and other general accounting duties as assigned.
Basic Qualifications:
  • At least 5 years’ Government Contract Billings experience.
  • Must have proven experience ensuring that all allowable costs are invoiced to the customers.
  • At least 3 years of experience in billings on different types of government contracts, such as Time & Materials (T&M), Cost Plus Fixed Fees (CPFF), Cost Plus Award Fees (CPAF), Firm Fixed Price (FFP), Estimate to Complete (ETC)
  • Minimum 5 years’ experience in accounting for a government contractor
  • Minimum 5 years’ experience with Jamis or Unanet  accounting systems.
  • Bachelors’ degree in related field or equivalent work experience
  • Must have proven initiative and ability to multi-task, solve problems, and self-prioritize.


Preferred Qualifications:
  • Ability to handle impromptu requests in a timely manner.
  • Excellent verbal and written communications skills
  • Excellent organizational and time management skills
  • Strong working knowledge of Microsoft Office Suite applications, specifically Excel
  • Flexibility and ability to meet deadlines and perform in a fast-paced collaborative work environment.
Excellent Benefits Plan Includes:

  • Health Insurance- medical, dental, vision & pharmacy benefits. (Employer contribution included)
  • Company sponsored Life Insurance.
  • 401K Retirement plan.
  • Generous PTO
  • Employee Assistance Program
  • Paid Holidays


Successful candidates will be subject to a background check and/or drug screening.
Reasonable Accommodation:
If you require alternative application or screening methods, don't hesitate to contact us directly to request accommodation. We strive to ensure that all individuals can perform their job duties satisfactorily, and reasonable accommodation will be made to enable individuals with disabilities to perform the essential functions of the role. Other duties may be assigned as necessary.
EEO Statement:
Capitol Bridge is an Equal Opportunity Employer. All employment decisions at Capitol Bridge are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental, or sensory disability, HIV status, sexual orientation, gender identity and/or expression, marital, civil union, or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.
Federal Contractor and E-Verify compliant.


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