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Claims Analyst
Trillium Professional is now seeking a Claims Analyst for a contract, remote position in Boston!
The assignment will last for 13 weeks. Schedule will be 40 hours per week. The pay rate is $38.22/hour.
The Claims Analyst – Pharmacy Revenue Cycle is responsible for managing complex pharmacy insurance claims, denials, and reimbursement issues to maximize revenue and ensure compliance with Medicare, commercial payer, and regulatory billing requirements. Working under the Revenue Cycle Supervisor, this individual researches denied and rejected claims, pursues insurance payments, analyzes reimbursement discrepancies, and collaborates with pharmacy and revenue cycle teams to improve billing accuracy and reduce claim rejections. This role requires strong analytical skills, healthcare billing expertise, and knowledge of pharmacy revenue cycle operations.
Key Responsibilities
-Research, analyze, and resolve rejected or denied pharmacy claims.
-Follow up with insurance companies regarding unpaid and underpaid claims.
-Review reimbursement issues, payer edits, and billing discrepancies.
-Interpret prescription drug orders and pharmacy billing documentation.
-Monitor claim edits and recommend workflow improvements to reduce denials.
-Ensure compliance with Medicare, commercial payer, and regulatory billing requirements.
-Process and monitor claims within Epic.
-Serve as a subject matter expert for complex denials, payment variances, fee schedules, and reimbursement issues.
-Collaborate with pharmacy and revenue cycle teams to improve collections and reduce avoidable write-offs.
Apply now!
Required Qualifications
-Bachelor’s degree in Business, Healthcare, or related field (or equivalent experience).
-1–3 years of experience in healthcare revenue cycle, coding, medical billing, patient accounting, or physician billing.
-Experience in a hospital, medical center, oncology, infusion, or specialty pharmacy environment preferred.
Strong knowledge of:
-Medicare and commercial payer billing
-CPT, HCPCS, and ICD-10 coding
-NCCI and MUE edits
-CMS-1500 claim forms
-Drug NDC numbers and Medicare billing unit conversions
-Epic billing workflows
Preferred Certifications
-Certified Pharmacy Technician (CPhT)
-CPC or RHIT Coding Certification
Trillium has been recruiting and placing clerical and office professionals for over 30 years. From Fortune 100 companies to small businesses, our philosophy remains the same: to achieve excellence by providing quality employees with an uncompromising level of service. We believe in honesty, integrity, and a simple philosophy of providing value to our customers and our employees. We strive to be unsurpassed in the recruitment and placement of professionals. Trillium is an Equal Opportunity Employer.
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Trillium offers a comprehensive benefit package that includes the ability to participate in health insurance and retirement plans, paid holidays, state required leave, and other leave, if applicable. Trillium’s offerings are dependent on the state in which the assignment is located, length of time worked, and may change depending on assignment. Benefit packages for direct hire placements vary based on the client company.
Contact Us if you have any questions
Our intentions are to fill job vacancies as quickly as possible with qualified candidates. We are always accepting applications if a time sensitive job has an application deadline it is noted in the job description. Click on "Apply" to begin the apply process.
