Offer summary

Qualifications:

Active pharmacist license required., Minimum of 2 years experience in pharmacy operations or claims management., Strong understanding of pharmacology and healthcare compliance., Proficiency with technology, including AI tools and claims management systems..

Key responsibilities:

Verify the accuracy of medications using AI-driven tools.

Review and submit insurance claims ensuring compliance and accuracy.

Facilitate data integration for onboarding new patients and hospitals.

Process monthly orders and handle customer queries from nursing homes and hospitals.

Job description

Key Responsibilities:

AI-Assisted Medication Verification:

Use AI-driven tools to verify the accuracy of medications packed into dose-ready sachets.
Cross-check AI-identified medications against prescriptions to ensure correct dosage and format.
Flagging where there is a missing or duplicater tablet or debris to be removed
Highlight patients who have missing data so they can be redone
Provide feedback on AI performance to improve accuracy and reliability.

Claims Review & Submission:

Review insurance/ government claims prior to submission to ensure accuracy and compliance with payer requirements.
Verify patient eligibility for financial assistance programs and document submitted to support claim
Check all paperwork for completeness and resolve discrepancies in documentation.
Collaborate with the billing team to streamline claims submission processes.

General Duties: Data Integration & Onboarding of new patients:

Facilitate the migration of data from external systems into our dispensing systems during the onboarding of new hospitals and nursing homes.
Validate and reconcile data to ensure accuracy and completeness.
Collaborate with onboarding teams to ensure a seamless integration process including phone communication through VOIP.

General Duties: Processing monthly orders from customers

Processing of monthly orders for current clients by reviewing the order placed and entering the order into the dispensing system

First line customer queries from nursing home and hospitals

First line queries from customers Confirming that the pharmacy you received an order? Expected delivery time?

Qualifications:

Active pharmacist license (state or national, as applicable)
2+ years of experience in pharmacy operations, claims management, or clinical pharmacy.
Familiarity with insurance claims, financial aid programs, and medication therapy management.
Strong understanding of pharmacology, medication identification, and healthcare compliance.
Proficiency with technology, including AI tools and claims management systems.
Exceptional attention to detail and analytical skills.

Preferred Skills:

Experience with medication packaging systems such as sachets or blister packs.
Knowledge of AI applications in healthcare or pharmacy operations.
Background in patient financial assistance programs or insurance processes.

Working Conditions:

Work Schedule: 3:00PM-12:00AM (may change depends on business needs)
Work Arrangement: Remote

About the Company

Outsource Accelerator is the trusted source for independent information, advisory and expert implementation of Business Process Outsourcing (BPO). We are the #1 Outsourcing Authority, and we offer the worlds leading aggregator marketplace for outsourcing.

We specifically provide the conduit between Philippines outsourcing suppliers and the businesses clients across the globe. We continue to provide world-class talent to help small and medium-sized enterprises successfully build their offshore team in the Philippines

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