Work From Home CPhT Claims Specialist
Company: The Elite Job
Location: United States
Employment Type: FULL_TIME, PART_TIME
Date Posted: 2025-11-07
Valid Through: 2026-11-07
Job Summary
The Elite Job is seeking a Certified Pharmacy Technician (CPhT) Claims Specialist to join our remote healthcare support team. In this role, you will manage and process pharmacy insurance claims, verify coverage, and resolve billing discrepancies. You will collaborate with pharmacists, healthcare providers, and insurance companies to ensure timely claim submissions and accurate reimbursements. This position is ideal for a detail-oriented and certified pharmacy technician who thrives in a fast-paced virtual environment while maintaining a strong commitment to accuracy and compliance.
Key Responsibilities
Process and review pharmacy claims in accordance with insurance and regulatory guidelines.
Verify patient eligibility, insurance coverage, and prescription benefits.
Identify and resolve claim rejections, billing errors, or discrepancies.
Communicate with healthcare providers, payers, and patients to clarify coverage and claim information.
Maintain accurate claim documentation and records within company systems.
Monitor claim statuses and ensure prompt follow-up on pending or denied claims.
Adhere to HIPAA regulations and maintain patient confidentiality at all times.
Assist in process improvements to enhance claims accuracy and efficiency.
Stay updated on pharmacy claim processing procedures and insurance policy changes.
Required Skills and Qualifications
Active Certified Pharmacy Technician (CPhT) license from the Pharmacy Technician Certification Board (PTCB) or equivalent.
High school diploma or GED required; associate degree preferred.
Strong knowledge of pharmacy billing, claims processing, and insurance coordination.
Excellent written and verbal communication skills.
High attention to detail with strong problem-solving skills.
Proficient in computer applications including Microsoft Office and pharmacy software systems.
Ability to manage confidential data responsibly and securely.
Strong organizational and time management abilities in a remote work setting.
Experience
Minimum 1–2 years of experience in pharmacy claims processing, billing, or a similar healthcare-related role.
Previous experience in a remote or virtual healthcare support environment is highly desirable.
Working Hours
Flexible remote work schedule with full-time and part-time options available.
Standard business hours (Monday to Friday), with occasional weekend shifts based on claim volume.
Candidates should have reliable internet connectivity and a quiet workspace for remote operations.
Knowledge, Skills, and Abilities
In-depth understanding of pharmacy claims, prior authorizations, and insurance reimbursement processes.
Ability to interpret insurance coverage policies and apply them accurately.
Excellent multitasking and time management skills under minimal supervision.
Customer-oriented approach with strong interpersonal skills.
Adaptability to evolving technologies and claim processing platforms.
Commitment to accuracy, compliance, and patient service excellence.
Benefits
Competitive pay with performance-based incentives.
100% work-from-home flexibility.
Health, dental, and vision insurance options.
Paid training and certification renewal support.
Career advancement opportunities within a growing healthcare organization.
Supportive, collaborative, and inclusive virtual work culture.
Why Join The Elite Job?
At The Elite Job, we value innovation, precision, and integrity in every role. Joining our remote pharmacy team gives you the opportunity to make a difference in patients healthcare experiences while enjoying flexibility and professional growth. You will work with a company that invests in your success, prioritizes work-life balance, and recognizes your contributions as essential to our mission of delivering efficient and reliable pharmacy claim services.
How to Apply
If you are a certified pharmacy technician seeking a rewarding remote position with a reputable organization, we would love to hear from you!
Submit your updated resume along with a brief cover letter highlighting your relevant experience and CPhT certification to us.
Only shortlisted candidates will be contacted for the next steps in the selection process.
