Pharmacy Claims & Operations Specialist

New Jersey Urology, LLC

Pharmacy Operations & Claims Reconciliation Analyst supporting pharmacy programs and financial performance. Collaborating with leadership and stakeholders to ensure claims accuracy and operational efficiency.

Posted 7/11/2026full-timeCherry Hill • New Jersey • 🇺🇸 United StatesJuniorMid-Level💰 $52,000 - $65,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in reconciling pharmacy claims and analyzing reimbursement discrepancies while coordinating with various stakeholders. Proficient in developing operational dashboards and reports to track pharmacy performance and reimbursement trends.

Highest-signal resume keywords

Pharmacy Claims ReconciliationHealthcare AnalyticsMicrosoft Excel ProficiencyAnalytical Problem-SolvingClaims Processing Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingReimbursement SupportData AnalysisRoot Cause AnalysisFinancial Record Reconciliation

Soft Skills

Organizational SkillsProblem-Solving Skills

Tools & Technologies

Microsoft ExcelOperational Dashboards

Industry Keywords

Pharmacy OperationsHealthcare OperationsPayer AgreementsPayment IntegrityKey Performance Indicators

About the role

Key responsibilities & impact

Reconcile pharmacy claims between dispensing systems, PBM remittance files, adjudication systems, vendor reports, and financial records.
Identify underpayments, overpayments, duplicate payments, reversals, and missing transactions.
Investigate reimbursement discrepancies and perform root cause analyses.
Validate claim payments against contractual reimbursement methodologies and payer agreements.
Coordinate with PBMs, payers, pharmacies, and internal stakeholders to resolve payment discrepancies.
Support recovery efforts for identified reimbursement variances and payment integrity opportunities.
Develop, maintain, and distribute operational dashboards and reports related to pharmacy performance, prescription volume, payer mix, reimbursement trends, and key performance indicators.

Requirements

What you’ll need

Bachelor's degree in Business, Finance, Healthcare Administration, Analytics, Pharmacy, or related field.
1–2 years of experience in pharmacy operations, healthcare operations, claims processing, healthcare analytics, medical billing, reimbursement support, or a related analytical role.
Experience working with healthcare, pharmacy, or claims data.
Proficiency in Microsoft Excel, including Pivot Tables, VLOOKUP/XLOOKUP, formulas, filtering, and data analysis.
Strong analytical, problem-solving, and organizational skills.

Benefits

Comp & perks

Comprehensive medical, dental, and vision plans
HSA / FSA
401(k) matching
Employee Assistance Program (EAP)