Payor Compliance Data Entry Specialist

Fuze Health • Remote - Colorado, TX

1d • $41,440 - $51,800 • Remote

About The Position

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.

Requirements

• 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.
• Ability to simultaneously work on several projects with the flexibility to reprioritize in a minimum amount of time
• Ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time
• Ability to stoop, bend, and reach for equipment and supplies
• Ability to make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers
• Ability to lift, carry, push, pull, and move light objects up to 20 pounds.
• Ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.
• Applicants must be authorized to work for any employer in the U.S. Alto Pharmacy, Fuze Health, LetsGetChecked, and Fuze Care Services can not take over, transfer, or sponsor any visa type at this time.

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

Benefits

• paid sick time
• workers’ compensation insurance
• unemployment insurance
• Minimum Essential Coverage (MEC) medical plan (focuses on preventive care—including annual checkups, screenings, immunizations, and prenatal care—at no cost when services are provided by an in-network provider)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed