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Payor Compliance Data Entry Specialist

Role overview

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

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

Key facts

Other skills

  • Computer Keyboards
  • Organizational Skills
  • Communication
  • Physical Flexibility
  • Time Management

About the company

Alto Pharmacy logo

Alto Pharmacy

Specialty Pharmacy

Alto is America’s leading digital pharmacy, transforming a $500 billion industry. Founded in 2015, Alto’s better pharmacy model is centered on the critical role of pharmacists as the final link in a person’s health journey. Alto combines expert pharmacist care with purpose-built technology to deliver a more convenient and affordable experience for those who need medication. To date, Alto has fulfilled more than three million prescriptions, expanded to twelve markets, and built a mobile app experience that makes it easier than ever to manage medications and chat with a pharmacist. As Alto continues its rapid growth, it remains customer obsessed, with an industry-leading NPS score of 86.

Company details

Company typeSME
IndustrySpecialty Pharmacy
Company size501 - 1000

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Job description

Job Summary
 

At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare. We empower millions to digitally connect with care providers, essential health resources and needed treatments – and enable care providers, employers, health plans and life sciences companies to meaningfully enhance quality, outcomes and value. We are dedicated to helping our partners evolve and modernize to meet emerging patient and marketplace needs.

Fuze Health’s foundation is built upon the strategic combination of several proven, technology-powered innovators in the digital health, diagnostics, and pharmacy sectors. Our growing portfolio brings together the capabilities of industry leaders including LetsGetChecked, Truepill, and Alto Pharmacy, to create a distinctive, unified force in healthcare. Together, we have the shared vision, advanced capabilities and talented teams to deliver next-generation solutions that patients and healthcare partners need today and into the future.



Job Description
 

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 Information
 

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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Marcus Rivera

Chief Revenue Officer

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