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Remote Medicare Appeals Pharmacist

A-Line Staffing Solutions

  • 19 days ago
  • Remote
  • $53 Per Hour
  • Contractor
  • Full-time

Highlights

We’re hiring a Remote Medicare Appeals Pharmacist to support Medicare Part D members and providers by ensuring cases are accurately set up, reviewing clinical information for decisioning, and completing clear documentation within required timelines. This is a productivity- and quality-driven role requiring strong clinical judgment and comfort working across multiple systems.

Numbers & Facts

Location (
Remote)
Job TypeContractor, Full-time
IndustryStaffing/Employment Agencies
Salary$53 Per Hour
Year Founded2004
HeadquartersUtica, MI, US
Websitehttp://www.alinestaffing.com/

Description

Remote Medicare Appeals Pharmacist

Location: Remote (U.S.)
Pay: $53.00/hour (W2)
Schedule: Full-time, set rotation (business hours between 7:00 AM–8:00 PM ET (Mon–Fri) and 7:00 AM–4:30 PM ET (Sat–Sun))
Training Schedule: Mon–Fri, 9:00 AM–5:30 PM ET (attendance is critical during the first 8–10 weeks)

Position Summary

We’re hiring a Remote Medicare Appeals Pharmacist to support Medicare Part D members and providers by ensuring cases are accurately set up, reviewing clinical information for decisioning, and completing clear documentation within required timelines. This is a productivity- and quality-driven role requiring strong clinical judgment and comfort working across multiple systems.

Job Responsibilities

Review internal notes, fax requests, and supporting documentation for Medicare appeals cases
Ensure case setup accuracy and complete clinical review to support appropriate determinations
Document decisions clearly and thoroughly according to guidelines and work instructions
Outreach to providers to obtain additional clinical details when necessary
Maintain compliance with CMS timelines and internal productivity/quality standards
Use drug information resources/compendia and Medicare guidance to support decisioning
Participate in coaching/feedback sessions with your supervisor to support continuous improvement

Qualifications

Active Pharmacist license in good standing in your state of residence
Bachelor’s degree in Pharmacy or PharmD
Strong computer skills; comfortable navigating multiple applications and dual screens
Ability to work independently in a metrics-driven environment

Skills

  • Medicare
  • Appeals
  • prior authorization
  • RPh
  • PHARMD

About Company

A-Line Staffing Solutions is a premier staffing company that supplies professionals to the Healthcare, Insurance, Pharmaceutical, and Information Technology industries.

Founded in 2004, A-Line Staffing Solutions has been a leader in matching talented individuals to the jobs that our clients NEED to fill. We are experts at offering creative staffing solutions to employers, and we are hiring every day.

A-Line Staffing can offer short-term, long-term and direct-hire opportunities to professionals across the United States. We hire only the most qualified and talented individuals in the country. Our recruiting, selection and stringent screening processes have strengthened our reputation for delivering quality customer service and unbeatable talent.

For our commissioned clients, A-Line Staffing closely follows the standards and practices established by The Joint Commission. For all of our clients and employees, our commitment to continual improvement combined with a strict code of ethics provides an atmosphere of respect and unparalleled professionalism.

To find out how A-Line Staffing Solutions can share our talent with you, please contact us today. We are eager to include you among our most valued and satisfied clients. If you are a professional and would like to learn more about open opportunities in your area, please contact us today. We are always searching for talented and enthusiastic professionals

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