Reimbursement Specialist

Reports to: Pharmacy Operations Leadership

About Zeal Specialty Pharmacy

At Zeal Specialty Pharmacy, we’re on a mission to make specialty care truly special—for patients, providers, partners, and one another. We are a nationally licensed, multi-accredited specialty pharmacy built on innovation, empathy, and purpose, dedicated to optimizing the patient experience through a combination of advanced technology and deeply human care. Our work goes beyond dispensing medications—we deliver clarity, confidence, and compassion at every step of the specialty journey.

Why Work for Zeal

At Zeal, every role matters because every person matters. Our culture is rooted in hospitality, excellence, innovation, character, and ambition, and those values guide how we serve patients and how we support one another as colleagues.

You’ll join a collaborative, people-first team that treats pharmacists as trusted professionals, values accuracy and integrity, and believes great care happens when individuals feel respected, supported, and empowered to do meaningful work. If you’re looking for a stable, purpose-driven environment where your expertise is valued and your work makes a real difference, Zeal is the place to grow your career.

About the Role

The Reimbursement Specialist -is responsible for the analysis and processing of insurance claims, ensuring accurate and timely reimbursement for specialty medication and services provided by our specialty pharmacy.

Responsibilities

· Review insurance coverage and benefits to determine eligibility for patient medications and services

· Responsible for reviewing claims, identifying discrepancies, and collaborating with insurance providers and patients

· Resolve claim issues, including denied or underpaid claims, by researching, appealing, and following up as needed

· Submit and track prior authorizations

· Maintain accurate and up-to-date records of claims submitted, payments received, and outstanding balances

· Provide assistance to patients regarding out-of-pocket costs, including but not limited to, utilizing copay card, financial assistance programs, foundational funding

· Ensure exceptional customer service by addressing patient and prescribers’ inquiries and concerns promptly and professionally

· Perform pharmacy fulfillment duties as needed

Qualifications

· High school diploma or equivalent; additional education or certification in pharmacy technology preferred.

· Minimum of 1-3 years of experience in a pharmacy setting, preferably with a focus on operations and reimbursement.

· Strong knowledge of pharmacy procedures and insurance processes.

· Excellent organizational and multitasking skills.

· Proficient in pharmacy management software and other relevant computer applications.

· Exceptional communication and interpersonal skills.

· Ability to work independently and as part of a team in a fast-paced environment.

· Detail-oriented with a high degree of accuracy.

This description has been reviewed as of the date below and will remain in-force associated

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person