Pharmacy Claims Manager
If your answer is "all of the above," consider joining our team at Consonus Pharmacy. It's a perfect opportunity for compassionate people dedicated to people's health and well-being.
Consonus Pharmacy is a closed-door long-term care pharmacy specializing in the needs of nursing facilities, assisted living residents, and their caregivers. We are currently hiring a Pharmacy Claims Manager to join our team!
As the Pharmacy Claims Manager your responsibilities will include (but are not limited to):
The Pharmacy Claims Manager is responsible for overseeing all pharmacy claims processing operations, including prescription adjudication, third-party billing, claim rejection management, and reimbursement optimization. This position leads a team responsible for ensuring accurate and timely claim submission, resolution of claim exceptions, compliance with PBM, Medicare Part D, Medicaid, and commercial payer requirements, and adherence to NCPDP standards.
The Pharmacy Claims Manager partners closely with Billing, Customer Accounts, and Pharmacy Operations to ensure accurate reimbursement and compliance, minimize claim write-offs, and ensure exceptional service to residents, facilities, and payers. In our Long-Term Care environment, there is focus on coordination with the Credentialing & Contracting team on payer enrollment issues, and management of LTC-specific reject queues related to transition fills, hospice billing, and facility census changes.
Some benefits may include:
Qualifications
EEO Statement
"Be here. Be you." For more than 30 years, Marquis Companies and Consonus Healthcare have been serving seniors and welcoming staff of all backgrounds, skills, and perspectives. The Marquis family of companies offer a rich heritage of embracing differences and honoring individuality. We've continued to grow in our appreciation of diversity in the workplace. We know it builds strength, drives innovation, and brings valuable new perspectives and energy. We're committed to making our workforce an even greater reflection of the people and communities we serve, and we are honored our employees have chosen to work at Marquis and Consonus. Everything we do as a company is driven by our mission to help those we serve, and each other, live the best rest of our lives. That means you being you without apology or compromise. We value your every uniqueness and continue to curate, nurture, and sustain an inclusive culture. It's the foundation of who we are and the evolution of our collective future.
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