Pharmacy Billing Representative

Westminster Senior Care Pharmacy; Orlando (FL); In loco; USD 42.000 - 54.000; Tempo pieno

Descrizione del lavoro

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.

Competenze

• 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.

Mansioni

• 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.

Conoscenze

LTC Billing

Medicare/Medicaid Knowledge

PDPs Knowledge

Third-Party Insurance

Data Entry

Communication Skills

Formazione

High School Diploma or equivalent

Strumenti

Frameworks

Descrizione del lavoro

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/

Experience

Required

• 1 - 3 years: Frameworks experience
• 1 - 3 years: LTC Billing experience

Education

Required

• High School or better

Equal Opportunity Employer
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