Pharmacy Billing Representative

Westminster Brand 051816; Orlando (FL); On-site; USD 42,000 - 58,000; Full time

Job summary

Longevity Scripts in Orlando is hiring a full-time Pharmacy Billing Representative to manage Medicare/Medicaid PDPs and third-party billing. You will educate staff, handle inquiries, prepare reports, and maintain resident profiles, ensuring accurate data entry and timely billing for assigned accounts.

Ideal candidates have 1–3 years LTC pharmacy billing experience, proficiency with Word/Excel, and strong organizational and problem-solving skills to thrive in a dynamic healthcare environment.

Qualifications

• High School Diploma or equivalent; proficiency in Word and Excel.
• 1–3 years LTC Pharmacy billing experience.
• 1–3 years' experience with Frameworks.
• Strong organizational skills with the ability to prioritize and multi-task; strong problem solving.

Responsibilities

• Resolve rejections, denials, and PA's with third party insurance claims (PDPs, Medicaid, etc.).
• Communicate about Medicare Part D coverage and PDPs with partners and stakeholders.
• Educate staff on PA processes and maintain resident profiles.
• Answer incoming calls.
• Advise residents on PDP options available.
• Prepare reports requested by management, customers and residents.
• Data entry support as needed.
• Billing responsibilities for assigned customers.

Skills

LTC Pharmacy billing

Medicare PDPs

Third-Party Insurances

Problem solving

Organizational skills

Education

High School Diploma or equivalent

Tools

Word

Excel

Job description

Longevity Scripts is seeking to fill a full-time Pharmacy Billing Representative position in our Orlando location. This position is responsible for providing knowledge of Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances to appropriate health care professionals, advising resident and appropriate parties on PDP options available, and enrolling and applying for low-income subsidy if applicable. EOE, DFWP- We honor those who serve.

Essential Job Functions:

• Responsible for resolution of Rejections, Denials, and PA's associated with third party insurance claims, e.g. PDPs, Medicaid, etc.
• Communication liaison regarding Medicare Part D coverage and PDPs with various business partners and stakeholders.

• Educates the staff on proper PA processes. Maintain accurate resident profiles.
• Answer incoming calls.
• Advises resident and appropriate parties on PDP options available.
• Prepares various reports as requested by management, customers and residents.
• Data Entry support, as needed.
• Billing responsibilities for assigned customers.

Minimum Qualifications

• High School Diploma or equivalent. Proficiency in Word and Excel.
• 1-3 years LTC Pharmacy billing experience.
• 1-3 years' experience with Frameworks
• Ability to demonstrate strong organizational skills including the ability to prioritize and manage multiple tasks in a dynamic environment.Ability to demonstrate problem solving and critical thinking skills.
• Knowledge of Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances. Knowledge of Pharmacy's computer software and the ability to process medication orders.

Applicants can learn more about Florida background screening requirements at https://info.flclearinghouse.com/