Claims Operations Coordinator

Who We Are: SmithRx is a rapidly growing, venture-backed  Health-Tech  company.  Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management ( PBM ) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service.  With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country. We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S  healthcare  system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values: Integrity:  Do the right thing. Especially when it’s hard. Courage:  Embrace the challenge. Together:  Build bridges and lift up your colleagues. Job Summary:   As a claim coordinator, your focus will be on providing exceptional customer service to our members by ensuring accurate claims processing for direct member reimbursements and coordinating disbursement of member communication letters.   What you will do: Responsible for ensuring timely comple tion of non - electronically processed claims such as d irect member reimbursement claims and c ommercial out - of - network claims Ensure claims approvals and/or denials are made in accordance with company practices and procedures Timely execute on member communications at scale, including mail - outs through our third - party mail vendor Support implementation activities related to claims management Prepares correspondence to members regarding potential medication disruption Maintain reimbursement queue to meet the departments SLA’s Protects patient health information by following regulations for HIPAA compliance Sustain integrity of all existing claims processes by ensuring all process documentation is up to date Assist Claims Analyst team members with implementation duties Participate in process improvement and quality assurance opportunities What will you bring to SmithRx: 3+ years of pharmacy technician experience or claims processing experience required Pharmacy Technician license preferred Customer service oriented with the ability to work well under pressure E xcellent organization skills with ability to prioritize, coordinate and simultaneously maintain multiple projects with high level of quality and productivity Microsoft Excel skills required Impeccable attention to detail and accuracy in work product Strong problem solving, written and verbal communication, and interpersonal skills Ability to work independently as well as part of an extended, cross - functional team Self - driven, results - oriented work ethic with a positive outlook Ability to take initiative with little to no direction What SmithRx Offers You:  Highly competitive wellness  benefits  including Medical, Pharmacy, Dental, Vision, Life insurance  Flexible Spending  Benefits  Discretionary Time Off  401(k) Retirement Savings Program  Paid Parental Leave  benefits Professional development and training opportunities