Alto Pharmacy
Specialty Pharmacy
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Job Description
Fuze Health is looking for a Payor Compliance Data Entry Specialist to join our Contracts & Reimbursement Team! You will be a vital part of our efforts to optimize Fuze Rx's reimbursement processes, assist with Pharmacy Benefit Manager audits, and uphold the company's core values and mission.
Key Responsibilities
Evaluate claims dispensed below Fuze Rx's cost as part of the negative margin review cycle
Submit and monitor maximum allowable cost appeals sent to pharmacy benefit managers
Manage pharmacy billing support tasks and resolve related claims issues
Support the payor compliance audit program by compiling detailed documentation and progress tracking
Required Experience & Qualifications
Minimum Qualifications:
Strong computer and organizational skills, with proficiency in Google Workspace, macOS, and database tools such as Looker.
Proficient in spreadsheet navigation and data management.
Advanced keyboard proficiency, including efficient use of keyboard shortcuts to maximize productivity.
Preferred Qualifications:
Ability to simultaneously work on several projects with the flexibility to reprioritize in a minimum amount of time
Additional Physical Job Requirements
Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.
Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Fuze Health’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.
Salary Range: $41,440 - $51,800
Commission Eligible: No
Location Requirement: limited to individuals residing in the following states: Arizona, Arkansas, California, Colorado, Florida, Kansas, Maryland, Missouri, Nevada, New Jersey, New York, North Carolina, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Washington (WA), and Wisconsin.
Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S. Alto Pharmacy, Fuze Health, LetsGetChecked, and Fuze Care Services can not take over, transfer, or sponsor any visa type at this time.
Benefits:STA (Short-Term Assignment) employees are eligible for legally required benefits, including paid sick time, workers’ compensation insurance and unemployment insurance, as well as the Company’s Minimum Essential Coverage (MEC) medical plan. This plan focuses on preventive care—including annual checkups, screenings, immunizations, and prenatal care—at no cost when services are provided by an in-network provider.
Application deadline- August 21, 2026
#LI-Remote
Equal Opportunity Employer
Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent@fuzehealth.com.
Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company.
Use of Automated Decision Tools
Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us at talent@fuzehealth.com.
Privacy Notice
To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants.
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