Data Production Specialist, Pharmacy Billing

ScriptPro LLC

2d•Remote

About The Position

Imagine working at a place where innovation meets impact, and every day brings new opportunities to revolutionize the pharmacy industry! At ScriptPro, you’ll be part of a dynamic team that’s at the cutting edge of technology, creating solutions that make a real difference in people’s lives. ScriptPro develops, sells, and supports state of the art robotics and services in thousands of pharmacy settings around the United States and Canada. The Pharmacy Strategy and Informatics department is a dynamic, forward‑thinking team that supports the pharmacy claim adjudication framework for ScriptPro’s customers. This group thrives on turning ideas into meaningful improvements that support pharmacies and strengthen ScriptPro’s overall mission. You’ll collaborate across the organization, contribute to innovative projects, and be part of a team that thrives in a fast‑evolving industry. We’re looking for someone who thrives on big‑picture thinking, creative problem‑solving, and making a meaningful impact. Job Summary: The Payer Sheet Specialist at ScriptPro plays a key role in supporting the insurance database within the Pharmacy Management System (PMS). This position involves interpreting national standards and collaborating with software developers and insurance data specialists to ensure accurate claim adjudication. The specialist will lead others, apply creative problem-solving, and utilize custom scripting and SQL to maintain and test payer sheets. Strong communication, organization, and a proactive approach to learning are essential for success in this role.

Requirements

Bachelor’s in Business, Finance or related field preferred
Fundamental programming experience
Working knowledge of the claim adjudication process for pharmacies
Familiarity with Microsoft Outlook, Word, Excel, Access
Rudimentary understanding of Structured Query Language (SQL)
Excellent communication and organizational skills
Self-motivated with the ability to follow department procedures and manage/prioritize workload
Polite, helpful, and positive with internal and external customers
Willingness to learn and meet new challenges with enthusiasm
Must have high-speed reliable internet access with a hard-wired connection
Must have a distraction free home office workspace
Must be willing to participate in video virtual meetings (camera on)

Responsibilities

Utilize ScriptPro’s payer sheet custom language to generate a desired claim submission output
Create the appropriate code to achieve a desired output
Describe what is happening in a particular field's/segment's code
Describe what dependencies exist for a particular field's/segment's code
Use ScriptPro’s internal adjudication simulator to properly test the payer sheet
Interpret exception errors and resolve problems with payer sheet syntax/operation
Perform payer sheet reviews and tests to ensure that ScriptPro standards are followed
Assist employees with software tests related to claim processing
Provide suggestions for departmental process improvements and workflow documentation
Process payer sheets in response to industry notifications received
Assist staff members with weekly data release procedures
Evaluate industry announcements for potential third party data modifications
Develop and execute basic to intermediate SQL queries
Collect utilization data sets to facilitate performance analytics
Perform other duties as assigned