Pharmacy Liability & Litigation Claims Specialist - Remote

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Written by AI from the job title and company, not by CCMSI, so some details may not match this job. The employer's own page has the real description.

Job Overview

CCMSI is seeking a dedicated Pharmacy Liability & Litigation Claims Specialist to join our remote team. In this role, you will be responsible for managing pharmacy-related liability claims and litigations, ensuring that claims are processed accurately and efficiently while adhering to company standards and regulatory requirements. You will play a critical role in investigating claims, coordinating with legal teams, and mitigating risks associated with pharmacy litigation. Your expertise will contribute to effective resolution strategies and maintain positive relationships with stakeholders.

Job Responsibilities

• Evaluate and manage pharmacy liability claims from initiation through resolution.
• Investigate claims by gathering relevant information and documentation.
• Collaborate with internal and external legal counsel to navigate litigation processes.
• Analyze claim trends and report findings to management for risk assessment.
• Maintain accurate and up-to-date records of claims correspondence and documentation.
• Provide recommendations for claims settlement, including payment and denial strategies.
• Stay informed about pharmacy law and regulations to ensure compliance.
• Assist in developing training materials related to pharmacy claims management.

Qualifications

• Bachelor's degree in pharmacy, law, healthcare management, or a related field.
• Minimum of 3 years experience in managing pharmacy claims or legal litigation.
• Strong understanding of pharmacy-related regulations and compliance requirements.
• Excellent analytical and problem-solving skills.
• Exceptional communication and interpersonal abilities.
• Proficient in claims management software and standard office applications.
• Ability to work independently and manage multiple priorities in a remote environment.

Technologies & Tools

The Pharmacy Liability & Litigation Claims Specialist will use a variety of technologies and tools to execute their responsibilities. Key software includes claims management systems for tracking and processing claims efficiently. Familiarity with legal research tools and pharmacy compliance software is also essential. Additionally, standard office applications such as Microsoft Office Suite will be utilized for documentation and reporting purposes.

Ideal Candidates

The ideal candidate for the Pharmacy Liability & Litigation Claims Specialist position is detail-oriented, highly organized, and possesses a strong commitment to integrity and ethical practices. They should be adept at critical thinking and have the ability to navigate complex legal environments. Strong interpersonal skills are essential for maintaining productive relationships with diverse stakeholders. A proactive attitude and an ability to adapt to evolving responsibilities within a dynamic remote work environment will further contribute to their success in this role.