Job Description

Job Title: Rejections Manager

Location: Bardonia, NY

Department: Pharmacy Corporate Billing

Reports to: VP of Operations & COO

Salary: $70,000-$80,000 + Bonus (Based on performance)

Benefits: Full benefits package

Position Overview:

The Rejections Manager is responsible for managing and overseeing the resolution of rejected insurance claims within the corporate billing department of our long-term care pharmacy. This role involves leading a team to identify, address, and resolve rejections efficiently while ensuring compliance with all insurance claims requirements. The manager will drive process improvements and help reduce claim rejection rates through effective management and team support.

This is a full-time, in-person role, with the possibility of a hybrid work model later on.

Key Responsibilities:

• Lead and manage the rejections team to efficiently handle and resolve rejected claims.
• Analyze rejection trends and implement strategies to reduce future rejections.
• Ensure accurate and timely resolution of rejected claims while maintaining compliance with insurance policies.
• Collaborate with the data entry team and other departments to resolve discrepancies that lead to rejections.
• Train and mentor team members on rejection resolution processes and software tools.
• Provide detailed reports and performance updates to the VP of Operations and COO.
• Continuously review and optimize the rejection management process to improve efficiency and success rates.

Qualifications:

• Proven experience in pharmacy rejection management and insurance claims processing.
• Strong leadership skills with a background in managing and developing teams.
• Experience in long-term care pharmacy billing is a plus.
• Excellent analytical skills and the ability to resolve complex rejection issues.
• Ability to multitask and manage priorities in a fast-paced environment.
• Familiarity with pharmacy management systems and claims processing software.

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