Pharmacy Billing Representative

Westminster Communities Of Florida; Orlando, Northern (FL, KY); Hybrid; USD 38,000 - 52,000; Full time

Job summary

Longevity Scripts in Orlando is seeking a full-time Pharmacy Billing Representative to manage Medicare/Medicaid PDPs and third-party claims for our LTC residents. The role includes advising on PDP options and enrolling for low-income subsidies where applicable.

The position requires knowledge of PDPs, Medicare Part D, and strong billing software skills, with 1–3 years of LTC pharmacy billing and relevant framework experience. Excellent organization and communication skills are essential.

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 ability to prioritize and manage multiple tasks.

Responsibilities

• Resolve rejections, denials, and PA-related third-party claims (PDPs, Medicaid, etc.).
• Communicate PDP coverage options with Medicare Part D and PDP partners.
• Educate staff on PA processes and maintain accurate resident profiles.
• Answer incoming calls and advise residents on PDP options.
• Prepare reports for management, customers and residents.
• Provide data entry support as needed.
• Handle billing responsibilities for assigned customers.

Skills

LTC Pharmacy billing

Medicare knowledge

Microsoft Word

Microsoft Excel

Organizational skills

Problem solving

Education

High School Diploma or equivalent

Tools

Pharmacy software

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
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