Hybrid LTC Pharmacy Billing Specialist (Remote)

WVE WVNH EMP LLC; West Virginia; Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) with company match

Paid time off

Job summary

CommuniCare Family of Companies is seeking a Pharmacy Billing Specialist to manage and update patient accounts, ensuring billing processes align with the billing manual throughout our hybrid/remote pharmacy network across WV, OH, IN, and MD.

You will verify insurance, work with Medicare Part D and managed care plans, and collaborate with facility managers to resolve census clarifications while maintaining compliance with HIPAA and all applicable regulations.

Qualifications

• Experience with pharmacy billing processes.
• Familiarity with Medicare Part D, Medicaid and managed care.
• Adherence to HIPAA regulations.

Responsibilities

• Follow billing processes per the billing manual to ensure consistency.
• Verify and update patient insurance information (Medicare Part D, Commercial, Medicaid).
• Collaborate with facility business office managers for Medicare Part D plans and Census clarifications.
• Daily reviews of SQL reports to ensure clean facility invoices.
• Adhere to federal and state regulations and company policies.

Skills

Billing software

Medicare Part D

HIPAA compliance

Long-Term Care billing

Tools

Framework LTC

Job description

CommuniCare Family of Companies is seeking a Pharmacy Billing Specialist to manage and update patient accounts, ensuring billing processes align with the billing manual throughout our hybrid/remote pharmacy network across WV, OH, IN, and MD.

You will verify insurance, work with Medicare Part D and managed care plans, and collaborate with facility managers to resolve census clarifications while maintaining compliance with HIPAA and all applicable regulations.