Medicare B Billing Specialist - Long-Term Care Pharmacy

Partners Pharmacy; Springfield (NJ); On-site; USD 38,000 - 52,000; Full time

Job summary

Partners Pharmacy in Springfield, NJ is seeking a Billing Representative to manage facility billing, Medicaid statuses, and daily data entry in a fast-paced long-term care setting. Responsibilities include responding to messages, updating resident records, reconciling claims, and coordinating with facilities to ensure Medicare B compliance and timely payments.

The role requires 1–3 years billing experience, a high school diploma, strong communication and multi-tasking skills, and a commitment to

Qualifications

• Experience in long term care or retail pharmacy environment.
• 1-3 years of Billing experience.
• Strong communication, problem solving and organizational skills.
• Must be able to work in a fast pace environment and meet deadlines.
• Typing, computer and multi-tasking skills are a must.
• Strong customer service skills.

Responsibilities

• Respond to voice messages and emails within 24-48 hours.
• Track and enter daily census for assigned facilities.
• Update system with face sheet information for residents in their assigned facilities.
• Handle facility and customer service inquiries.
• Review and update system with resident information received from contracts for assigned facilities.
• Handle re-bill rejections resulting from status changes for assigned facilities.
• On a monthly basis, handles all aspects of facility and private billing for assigned facilities.
• On a monthly basis, contacts Unysis, CMS, and facilities to follow up on pending Medicaid statuses.
• On a weekly/bi-weekly basis, review the pre-billing report for their assigned facilities.
• Maintains and fosters positive work environment within the billing and admissions departments.
• Communicates effectively with all company personnel.
• Aware of all compliance documentation needed for Medicare B Billing requirements.
• Follow Up procedures-needs to be able to follow up with doctors and facilities for necessary Medicare B compliance documentation
• Reconcile claims including secondary claims
• Research the different reconciliation for each state
• Keep complete files for each Med B patient.
• Participates in ongoing education and new compliance issues for appropriate billing of Medicare B claims
• Maintains confidentiality, security and integrity of PHI information
• Need to communicate any issues to Third Party manager that need to be addressed or any issues that need to be resolved.

Skills

Long-term care experience

Billing software

Customer service

Attention to detail

Communication skills

Education

High School Diploma or equivalent

Job description

Partners Pharmacy in Springfield, NJ is seeking a Billing Representative to manage facility billing, Medicaid statuses, and daily data entry in a fast-paced long-term care setting. Responsibilities include responding to messages, updating resident records, reconciling claims, and coordinating with facilities to ensure Medicare B compliance and timely payments.

The role requires 1–3 years billing experience, a high school diploma, strong communication and multi-tasking skills, and a commitment to