RX Loads Specialist I

    • Job Tracking ID: 512935-773131
    • Job Location: Meridian, ID
    • Job Level: Entry Level (less than 2 years)
    • Level of Education: High School/GED
    • Job Type: Full-Time/Regular
    • Date Updated: June 10, 2021
    • Years of Experience: Up to 2 Years
    • Starting Date: ASAP
    • Salary Type:: Hourly
    • Rate:: $12.75
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Job Description:

$12.75

The RX Loads Specialist I is responsible for all aspects that are included in the PBM invoice remittance process. This includes monitoring receipt of prescription claims files and invoices, and performing reconciliation prior to loading in adjudication system. Processes claims files through adjudication system. Performs final reconciliation of file to prepare for check remittance. Verifies payment issued match expected invoice amount.

Key Function

  • Reconciles claims data file to invoice for each billing cycle.
  • Generates and posts reports to appropriate folder locations for each billing cycle.
  • Loads claims files in GBAS and validates any exceptions that fail to load.
  • Finalizes all claims on the data load, and troubleshoots discrepancies as necessary.
  • Forwards completed files to Client Accounting for payment remittance, and ensures check is issued and verified in a timely manner.
  • Identifies any areas of concerns or negative impact to the client and or organizations
  • Maintains 5-7 business day TAT (Turnaround Time) on invoice remittance process.
  • Maintains 96%+ TAT and accuracy standards on a monthly basis.
  • Communicates effectively with PBM team members and external department contacts.
  • Performs other duties as assigned or needed.

Experience and Skills:

  • High school degree or equivalent.
  • Two years’ experience in accounting or bookkeeping.
  • Team and goal oriented.
  • Ability to maintain excellent working relationships with all departments.
  • Attention to detail.
  • Self-motivated.
  • Good problem solving and analytical skills.
  • Must maintain good customer service relationships with internal and external customers.
  • Completes all projects in a timely and accurate manner.
  • Types 45 wpm, 10-key by touch, and computer knowledge.
  • Able to demonstrate excellent attendance and punctuality with minimal unscheduled absences.
  • Excellent customer service attitude and professionalism.
  • Demonstrate Accuracy, Customer Service, Timely Turn-Around (ACT).
  • Exceptional verbal and written communication skills.
  • Proficiency using Microsoft Office (Word, Excel, Outlook, etc.).
  • Ability to work efficiently, perform multi-tasking, prioritize tasks, and meet tight deadlines.
  • Possess a high degree of integrity and discretion, as well as the ability to adhere to both company policies and best practices.
  • Ensure compliance with security practices and procedures, including HIPAA and HITRUST standards.
  • Ability to efficiently and effectively perform the Key Result Areas with or without a reasonable accommodation without posing a direct safety threat to others or self.
  • Protect and enhance the Core Purpose and the Core Values of AmeriBen.

AmeriBen is an Equal Opportunity/Affirmative Action Employer committed to creating an environment of diversity and inclusion for equal employment and advancement opportunities to all employees and applicants for employment. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, national origin, sex, sexual orientation, gender identity and/or expression, genetic information, disability, veteran or military status, or any other category protected by federal, state and/or local law.

If you are unable to use our online application process due to a disability, please contact the Human Resources Department at humanresources@ameriben.com.