Claims Analyst jobs in Pittsburgh, PA

7,000 Diseases - 500 Treatments - 1 Rare Pharmacy

PANTHERx is the nation’s largest rare disease pharmacy, and we put the patient experience at the top of everything that we do. 

If you are looking for a career in the healthcare field that embraces authentic dedication to patient care, you don’t need to look beyond PANTHERx. In every line of service, in every position and area of expertise, PANTHERx associates are driven to provide the highest quality outcomes for our patients.   

We are seeking team members who:

Are inspired and compassionate problem solvers;

Produce high quality work; 

Thrive in the excitement of the ever-challenging environment of modern medicine; and 

Are committed to achieving superior health outcomes for people living with rare and devastating diseases. 

At PANTHERx, we know our employees are the driving force in what we do. We cultivate talent and encourage growth within PANTHERx so that our associates can continue to explore their interests and expand their careers. Guided by our mission to provide uncompromising quality every day, we continue our strategic growth to further reach those affected by rare diseases.  

Join the PANTHERx team, and define your own RxARE future in healthcare!

Location: Pittsburgh, PA; Remote with occasional on-site work requirements

Classification: Non-Exempt

Status: Full-Time

Reports To: Supervisor, Claims

Purpose:

The Claim Analyst verifies patient pharmacy and medical claims accurately and quickly. This role liaises between patients, insurance companies, and government agencies to ensure patient receives medication accurately and timely and the appropriate entity is being billed. 

Responsibilities:

• Verifies patient pharmacy and medical coverage & processing info.
• Abilities to process pharmacy claims on the patient’s behalf through a pharmacy benefit system.
• Abilities to verify medical benefits accurately on patient’s behalf.
• Obtains authorizations & overrides as needed.
• Applies patients for copay cards and/or assistance programs.
• Discusses with patient to review patient financial responsibility, obtain patient consent and payment.
• Ensures proper shipment set up.
• Works special projects.
• Attends staff meetings.
• Other tasks as assigned.

Required Qualifications:

• High school diploma or general education degree (GED).
• Minimum 2 years’ experience processing pharmacy claims.
• Strong written and verbal communication skills necessary to convey ideas professionally and effectively.
• Ability to multitask.
• Proficient with EDS billing systems, Excel, and Word.

Preferred Qualifications:

• Experience or knowledge within the healthcare industry, particularly a mail order or specialty pharmacy
• Experience with CPR

Work Environment:

PANTHERx Rare Pharmacy offers flexibility only to eligible employees to work hybrid or remotely without compromising work performance, productivity, or team collaboration.  This role routinely uses standard office equipment such as computers and phones.

Physical Demands:

While performing the duties of this job, the employee is regularly required to talk, hear, and see. The employee frequently is required to sit, stand, and walk; use hands and fingers, handle or feel; reach with hands and arms and see a computer screen. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function of the job.

Benefits:

Hybrid, remote and flexible on-site work schedules are available, based on the position.  PANTHERx Rare Pharmacy also affords an excellent benefit package, including but not limited to medical, dental, vision, health savings and flexible spending accounts, 401K with employer matching, employer-paid life insurance and short/long term disability coverage, and an Employee Assistance Program!   Generous paid time off is also available to all full-time employees, as well as limited paid time off for part-time employees.  Of course we offer paid holidays too!

Equal Opportunity:

PANTHERx Rare Pharmacy is an equal opportunity employer, and does not discriminate in recruiting, hiring, promotions or any term or condition of employment based on race, age, religion, gender, ethnicity, sexual orientation, gender identity, disability, protected veteran's status, or any other characteristic protected by federal, state or local laws.