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Medical Claims Processor (Pharmacist Preferred)
Location: Remote (Karachi, Pakistan)
Job Type: Full-time (Remote)
Working Hours: 9:00 AM – 6:00 PM (CT) | 7:00 PM – 4:00 AM (PKT)

About the Company

SMB Services is hiring on behalf of a fast-growing U.S.-based healthcare technology company that is transforming the way patients access healthcare services. The organization leverages technology to simplify healthcare processes, improve patient experiences, and support healthcare providers through efficient, data-driven solutions. As part of its continued growth, the company is looking for detail-oriented professionals to join its remote operations team.

About the Role

We are seeking a highly organized and detail-oriented Medical Claims Processor to support the review and processing of medical claims. In this role, you will analyze medical billing documentation, verify medication-related charges, and communicate with healthcare providers and patients to obtain the information required for accurate claim processing.

This opportunity is ideal for candidates with strong analytical abilities, excellent written communication skills, and an interest in U.S. healthcare, pharmacy, or medical claims administration. Candidates with a pharmacy background are strongly preferred.

Key Responsibilities

• Review medical billing statements, Explanation of Benefits (EOBs), medical records, and supporting documentation.

• Verify medication-related charges and identify missing or incomplete information required for claim processing.

• Communicate professionally via email with patients, physician offices, pharmacies, insurance representatives, and other healthcare providers to obtain necessary documentation.

• Maintain accurate, organized, and detailed records of all claim-related activities.

• Process claims in accordance with company policies, quality standards, and established procedures.

• Ensure high levels of accuracy while managing multiple claims and meeting productivity targets.

• Work independently in a remote environment while adhering to deadlines and quality expectations.

 

Qualifications

• PharmD or B.Pharm is highly preferred.

• Candidates with backgrounds in healthcare, life sciences, medical billing, or medical claims processing are encouraged to apply.

• Excellent written and verbal English communication skills.

• Strong analytical, organizational, and problem-solving abilities.

• High attention to detail with the ability to review large volumes of documentation.

• Proficiency in Microsoft Office (Word, Excel, and Outlook).

• Comfortable learning new software and systems.

• Ability to work independently and effectively in a remote work environment.

 

Education

• High school diploma or equivalent is required.

• Bachelor’s degree in Pharmacy, Life Sciences, Healthcare, or a related discipline is preferred.

 

Preferred Experience

• Experience reviewing medical records, insurance claims, Explanation of Benefits (EOBs), or pharmacy documentation.

• Familiarity with U.S. healthcare, pharmacy operations, medical billing, or health insurance processes.

• Previous experience in medical claims processing, healthcare administration, customer support, or a related healthcare role is an advantage.