Hybrid Pharmacy Billing Specialist – LTC & Medicaid Claims

Grane Rx; Pittsburgh (Allegheny County); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Grane Rx, located in Pittsburgh, PA, is seeking a Billing Associate to collaborate with Billing, Accounting, Pharmacist, and Order Entry teams. The role involves external communication with customers and third-party insurance personnel, data entry, and Medicaid claim processing. Hybrid work arrangement available.

The ideal candidate has 1-5 years in LTC pharmacy billing and a Certified Pharmacy Technician credential, with a HS diploma and a preferred bachelor's degree.

Qualifications

• Bachelor's degree preferred; High School diploma required.
• 1-5 years of LTC Pharmacy and billing experience preferred.
• Certified Pharmacy Technician certification.

Responsibilities

• Data entry and review of patient demographics.
• Correspond with facility and family representatives to gather demographic information for billing validation.
• Perform daily tasks as assigned by the Billing team.
• Adhere to Grane Rx billing and denial management processes and procedures.
• Review and process Medicaid pending claims.
• Perform census reconciliation procedures to ensure census data alignment with facility records.
• Process Third Party Claims and rebills as needed.
• Produce month-end and interim reports.

Skills

LTC Pharmacy Billing

Data entry

Customer communication

Education

Bachelor's degree preferred

High School diploma required

Certified Pharmacy Technician

Job description

Grane Rx, located in Pittsburgh, PA, is seeking a Billing Associate to collaborate with Billing, Accounting, Pharmacist, and Order Entry teams. The role involves external communication with customers and third-party insurance personnel, data entry, and Medicaid claim processing. Hybrid work arrangement available.

The ideal candidate has 1-5 years in LTC pharmacy billing and a Certified Pharmacy Technician credential, with a HS diploma and a preferred bachelor's degree.