Pharmacy Billing Representative

Westminster Senior Care Pharmacy in; Orlando (FL); On-site; USD 42,000 - 60,000; Full time

Job summary

Westminster Pharmacy Services in Orlando, FL is seeking a full-time Pharmacy Billing Representative to manage Medicare, Medicaid, PDPs and third-party insurances. You will resolve rejections/denials, advise on PDP options, and support billing for assigned accounts.

The ideal candidate has 1–3 years LTC pharmacy billing experience, proficiency in Word and Excel, and strong organizational and problem-solving skills to handle multiple tasks in a fast-paced 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.
• Ability to prioritize and manage multiple tasks in a dynamic environment; strong problem-solving skills.
• Knowledge of Medicare, Medicaid, PDPs and Third-Party Insurances; familiarity with pharmacy software.

Responsibilities

• Resolve rejections, denials, and PAs for third-party insurance claims (PDPs, Medicaid).
• Communicate PDP coverage details with partners and stakeholders.
• Educate staff on PA processes; maintain resident profiles.
• Answer incoming calls.
• Advise residents on PDP options available.
• Prepare reports for management, customers and residents.
• Data entry support as needed.
• Billing responsibilities for assigned customers.

Skills

Strong organizational skills

Problem solving & critical thinking

Multitasking in dynamic environment

Communicate with healthcare partners

Education

High School Diploma or equivalent

Tools

Word

Excel

Job description

Westminster Pharmacy Services
Orlando, FL 32801, USA

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.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.