Claims Analyst (second shift)

PANTHERx Rare Pharmacy is looking for patient-centered team members to support claims processing in our growing operations! Second shifts available as well as condensed work weeks!

Location: Pittsburgh, PA; This position is currently fully remote with occasional on-site work requirements

Classification: Non-Exempt

Status: Full-Time, Second Shift (condensed work week available)

Purpose

The role of the Claim Analyst is to verify patient pharmacy and medical claims accurately and quickly. Claim Analysts will also liaise between patients, insurance companies, and government agencies to ensure patient receives medication accurately and timely and the appropriate entity is being billed. This position reports to the Supervisor, Claims.

Responsibilities

• Verify patient pharmacy and medical coverage & processing info
• Ability to process pharmacy claims on the patient’s behalf through a pharmacy benefit system
• Ability to verify medical benefits accurately on patient’s behalf
• Obtain authorizations & overrides as needed
• Apply patients for copay cards and/or assistance programs
• Discussion with patient to review patient financial responsibility, obtain patient consent and payment
• Ensure proper shipment set up
• Work special projects
• Attend staff meetings
• Other tasks as assigned

Required Qualifications

• High school diploma or general education degree (GED)
• Minimum 2 years’ experience processing pharmacy claims
• Strong written and verbal communication skills necessary to professionally and effectively convey ideas
• Ability to multitask
• Proficient with EDS billing systems, Excel and Word

Preferred Qualifications

• Experience or knowledge within the healthcare industry, particularly a mail order or specialty pharmacy
• Experience with CPR+

Work Environment

PANTHERx Rare Pharmacy offers flexibility only to eligible employees to work hybrid or remotely without compromising work performance, productivity, or team collaboration. This role routinely uses standard office equipment such as computers and phones.

Physical Demands
While performing the duties of this job, the employee is regularly required to talk, hear, and see. The employee frequently is required to sit, stand, and walk; use hands and fingers, handle or feel; reach with hands and arms and see a computer screen. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function of the job.