LTC Pharmacy Billing & PDP Specialist

Westminster Senior Care Pharmacy; Orlando (FL); On-site; USD 42,000 - 54,000; Full time

Job summary

Longevity Scripts in Orlando is seeking a full-time Pharmacy Billing Representative to handle Medicare, Medicaid, PDPs, and third-party insurance claims. The role requires strong knowledge of PDP options and eligibility processing.

You will resolve rejections and denials, educate staff on PA processes, manage resident profiles, perform data entry, and generate reports for management and customers. 1-3 years LTC billing and Frameworks experience preferred.

Qualifications

• High School Diploma or equivalent required.
• 1-3 years LTC Pharmacy billing experience.
• 1-3 years' experience with Frameworks.
• Knowledge of Medicare, Medicaid, PDPs and Third-Party Insurances.

Responsibilities

• Resolve rejections, denials, and PA’s associated with third party insurance claims (PDPs, Medicaid, etc).
• Serve as communication liaison regarding Medicare Part D coverage and PDPs with business partners.
• Educate staff on proper PA processes and maintain accurate resident profiles.
• Answer incoming calls and advise residents on PDP options.
• Prepare various reports as requested by management, customers and residents.
• Provide data entry support as needed and handle billing responsibilities for assigned customers.

Skills

LTC Billing

Medicare/Medicaid Knowledge

PDPs Knowledge

Third-Party Insurance

Data Entry

Communication Skills

Education

High School Diploma or equivalent

Tools

Frameworks

Job description

Longevity Scripts in Orlando is seeking a full-time Pharmacy Billing Representative to handle Medicare, Medicaid, PDPs, and third-party insurance claims. The role requires strong knowledge of PDP options and eligibility processing.

You will resolve rejections and denials, educate staff on PA processes, manage resident profiles, perform data entry, and generate reports for management and customers. 1-3 years LTC billing and Frameworks experience preferred.