Pharmacy Billing & Insurance Specialist (Evenings/Weekends)

SpecialtyRx, Inc; Ridgefield Park (NJ); On-site; USD 25,000 - 30,000; Full time

Job summary

SpecialtyRx, Inc. in Ridgefield Park, NJ is seeking a Billing Representative with Pharmacy experience to join our team. The role involves researching patient eligibility with insurers, processing rejections, and maintaining accurate billing records.

Responsibilities also include submitting prior authorizations, communicating with insurance providers, and coordinating with facilities and CMS/NJM/NYM as needed. Onsite training for three weeks is required, with evening and weekend availability.

Qualifications

• H.S. diploma or equivalent.
• Courteous and polite phone skills.
• Computer literate.
• Ability to work nights and weekends.
• Previous experience in Retail pharmacy is a must.
• Experience in Long Term Care Pharmacy. (Preferred)
• Must be able to work independently and as a team.
• The ability to multitask and work in a fast-paced environment is a must.
• Experience in New York Pharmacy billing claims. (Preferred)
• Frameworks/ECM knowledge is a plus.
• Must be detail-oriented.

Responsibilities

• Perform duties assigned by the Billing Supervisor.
• Research and establish patient eligibility coverage with insurance providers (state and private)
• Determine and process insurance rejections by the daily report.
• Maintain and update patient billing and insurance information in the system.
• Submit prior authorizations for State insurance.
• Interact with the insurance company on daily basis regarding overrides, rejections, and insurance updates.
• Interact with client facilities staff, PDP (Medicare), CMS, NJM, and NYM when necessary.
• Follow up and resolved pending billing issues.

Skills

Phone skills

Computer literacy

Multitasking

Detail oriented

Team player

Education

High School diploma or equivalent

Tools

ECM knowledge

Job description

SpecialtyRx, Inc. in Ridgefield Park, NJ is seeking a Billing Representative with Pharmacy experience to join our team. The role involves researching patient eligibility with insurers, processing rejections, and maintaining accurate billing records.

Responsibilities also include submitting prior authorizations, communicating with insurance providers, and coordinating with facilities and CMS/NJM/NYM as needed. Onsite training for three weeks is required, with evening and weekend availability.