Payor Compliance Data Entry Specialist

This is a fully remote position, open to applicants in Arizona, +16 more states.

📋 Description

• Assess claims issued below Fuze Rx's cost as part of the negative margin review process.

• Initiate and oversee maximum allowable cost appeals directed to pharmacy benefit managers.

• Oversee pharmacy billing support activities and address related claims concerns.

• Assist the payor compliance audit initiative by gathering comprehensive documentation and tracking progress.

⛳️ Requirements

• Excellent computer and organizational abilities.

• Skilled in Google Workspace, macOS, and database applications like Looker.

• Proficient in navigating spreadsheets and managing data.

• Advanced keyboard skills, including effective use of keyboard shortcuts.

• Capability to manage multiple projects simultaneously and quickly adjust priorities.

• Ability to work at a computer terminal using a monitor, keyboard, and mouse for extended durations.

• Capacity to stoop, bend, and reach for equipment and supplies.

• Competence to perform frequent repetitive wrist, hand, and finger movements.

• Ability to lift, carry, push, pull, and move light objects weighing up to 20 pounds.

• Proficient in effective communication through verbal interactions, auditory discernment, and visual perception of details.

• Applicants must be authorized to work for any employer in the U.S.

• Applicants must reside in one of the following states: Arizona, Arkansas, California, Colorado, Florida, Kansas, Maryland, Missouri, Nevada, New Jersey, New York, North Carolina, Oregon, Pennsylvania, South Carolina, Tennessee, Washington, or Wisconsin.

🏝️ Benefits

• Short-Term Assignment employees qualify for legally mandated benefits, including paid sick leave, workers’ compensation insurance, and unemployment insurance.

• Company’s Minimum Essential Coverage (MEC) medical plan.

• Preventive care encompassing annual checkups, screenings, immunizations, and prenatal care at no charge when services are provided by an in-network provider.

• Reasonable accommodations for qualified individuals with disabilities.