Fuze Health is looking for a Payor Compliance Data Entry Specialist to join our Contracts & Reimbursement Team! You will be a vital part of our efforts to optimize Fuze Rx's reimbursement processes, assist with Pharmacy Benefit Manager audits, and uphold the company's core values and mission.
Key Responsibilities
- Evaluate claims dispensed below Fuze Rx's cost as part of the negative margin review cycle
- Submit and monitor maximum allowable cost appeals sent to pharmacy benefit managers
- Manage pharmacy billing support tasks and resolve related claims issues
- Support the payor compliance audit program by compiling detailed documentation and progress tracking
Required Experience & Qualifications
Minimum Qualifications:
- Strong computer and organizational skills, with proficiency in Google Workspace, macOS, and database tools such as Looker.
- Proficient in spreadsheet navigation and data management.
- Advanced keyboard proficiency, including efficient use of keyboard shortcuts to maximize productivity.
Preferred Qualifications:
- Ability to simultaneously work on several projects with the flexibility to reprioritize in a minimum amount of time
