Claims Support Administrator
Fixed Term Contract (This role is a 6 month fixed term contract however it may develop on from that into a permanent role)
You will be working with the Finance Department & Superintendent Pharmacist in controlling the claims process for 60 + pharmacies across a network. Ensuring that all valid claims in the network under each of the States’ drug reimbursement schemes are claimed on a monthly basis. Working with the Superintendent Pharmacists to ensure that issues around rejected claims are resolved in a timely and efficient manner. Maximising the head office MPS system to support claims process each month. Tagging of MPS product on head office product file. Communicating with Managing Pharmacists & Retail Business Manager’s on issues around rejected claims.
MAIN DUTIES & RESPONSIBILITIES
Ensuring pharmacies are submitting claims in a timely manner each month. Supporting pharmacies to ensure rejected claims are resubmitted within agreed timelines. Reconciling claims at pharmacy level to payments received under reimbursement schemes Analysis and reporting of unpaid and rejected claims Communicating with PCRS regarding outstanding resubmitted claims. Communicating issues around rejected claims to the relevant managers in the business. Communicate with PCRS regarding changes to reimbursement. Provide training on any recurrent issues around claims. Monthly reporting to FD, Operations Director and Superintendent Pharmacist.
QUALIFICATION, EXPERIENCE & SKILLS REQUIRED
Pharmacist technician or Finance Assistant with previous claims management experience gained in a retail pharmacy or private healthcare setting. An understanding of the States drug reimbursement schemes is desirable but not essential. Excellent knowledge of Microsoft office. Excellent communication skills. Strong interpersonal skills essential. Attention to detail and ability to follow up essential. Build relationships across the business.
Alternatively you can simply email an up to date CV to barbara @pharmaconex.com and she will be in touch shortly.