Pharmacist

Pharmacist – Managed Care / MedicareLocation: RemoteDuration: 12-Month ContractPay Rate: $53–$55/hour on W2 (Negotiable)Position OverviewWe are seeking a licensed Pharmacist with experience in Medicare Part B pharmacy operations to support prescription processing, claims adjudication, and reimbursement activities. The ideal candidate will have a strong understanding of Medicare Part B billing requirements, CMS regulations, and pharmacy workflows while ensuring accurate, compliant, and timely prescription dispensing.Key ResponsibilitiesReview, verify, and dispense prescriptions in accordance with state and federal pharmacy regulations.Process and adjudicate Medicare Part B pharmacy claims accurately and efficiently.Ensure compliance with CMS guidelines and Medicare Part B billing requirements.Review physician documentation to verify medical necessity and coverage eligibility.Resolve claim denials, rejections, and reimbursement issues.Collaborate with physicians, patients, and insurance providers to obtain required documentation.Counsel patients on medication therapy, Medicare Part B benefits, and proper medication use.Maintain accurate pharmacy records while ensuring compliance with HIPAA and company policies.Support quality assurance initiatives and process improvements.Stay current with Medicare Part B regulations, reimbursement policies, and pharmacy best practices.Required QualificationsActive Pharmacist (RPh) license in good standing.PharmD or Bachelor's Degree in Pharmacy from an accredited institution.Experience processing Medicare Part B pharmacy claims.Strong understanding of CMS regulations, Medicare Part B billing, and reimbursement.Experience with pharmacy claims adjudication and prior authorization processes.Excellent communication, analytical, and customer service skills.Ability to work independently in a fast-paced environment.Preferred QualificationsExperience in retail, specialty, mail-order, infusion, or ambulatory pharmacy settings.Knowledge of DMEPOS billing and Medicare documentation requirements.Experience using pharmacy management systems and electronic prescription platformsWork Schedule8-hour shifts on a rotating schedule.Monday – Friday: Between 7:00 AM – 8:00 PM EST.Saturday & Sunday: Between 7:00 AM – 4:30 PM EST.Candidates must be flexible to work assigned shifts, including weekends.Training & AttendanceAttendance is mandatory during the onboarding and training period.First 8 weeks: Monday–Friday, 9:00 AM – 5:30 PM EST.No planned time off should be scheduled during the initial training period.