Pharmacy Billing Representative

Westminster-Communities-of-Florid; Orlando (FL); On-site; USD 40,000 - 56,000; Full time

Job summary

Longevity Scripts in Orlando, FL is seeking a full-time Pharmacy Billing Representative to manage third-party billing, PDPs, and Medicare/Medicaid communications for our LTC residents. You will resolve rejections, educate staff on PDP options, handle data entry, and generate reports for management and customers.

The ideal candidate has 1–3 years LTC pharmacy billing experience, strong Excel skills, and knowledge of Medicare programs.

Qualifications

• Knowledge of Medicare, Medicaid, PDPs and third-party insurances.
• Experience with LTC pharmacy billing.
• Proficiency in Word and Excel.
• Strong organizational and problem-solving skills.

Responsibilities

• Resolve rejections, denials, and PA’s for third-party claims (e.g., PDPs, Medicaid).
• Liaise with Medicare Part D coverage and PDPs with partners and stakeholders.
• Educate staff on PDP processes and maintain accurate resident profiles.
• Answer incoming calls and advise on PDP options.
• Prepare reports for management, customers and residents.
• Data entry support and billing for assigned customers.

Skills

Medicare knowledge

Medicaid knowledge

PDP knowledge

Excel

Word

Time management

Education

High School Diploma

Tools

Frameworks

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.