Pharmacy Billing Specialist

Elderwood Administrative Services; Eggertsville (NY); On-site; USD 20,000 - 29,000; Full time

Benefits offered by this job

Full Benefits Package - Medical,Dental

401(k) with company match

Weekly Paycheck

Job summary

Woodmark Pharmacy of NY is seeking a Pharmacy Billing Specialist who will perform electronic billing of Medicare, Medicaid, and third-party claims using the Framework LTC system. This on-site, full-time role requires accuracy, reliability, and strong customer service skills to support residents and families.

The ideal candidate has pharmacy billing experience, familiarity with Sage 300 and Microsoft Office 365, and the ability to work in a fast-paced long-term care setting.

Qualifications

• Experience in medical billing/collections in LTC or pharmacy
• Knowledge of Medicare/Medicaid billing
• Strong customer service and phone skills
• Proficient in Microsoft Office 365

Responsibilities

• Electronic billing of Medicare, Medicaid and Third Party Insurance pharmacy claims utilizing Framework LTC Pharmacy system.
• Billing for Skilled Nursing Facility, Assisted Living Facility and private pay pharmacy claims.
• Troubleshoot rejected insurance claims to maximize payments.
• Handle Prior Authorizations from Third Party Insurance.
• Bill/Invoice Review and Medicaid status updates.

Skills

Pharmacy billing

Medicare/Medicaid claims

Customer service

Sage 300

Framework LTC

Microsoft Office 365

Time management

Problem solving

Education

Associates or HS diploma

Tools

Sage 300

Framework LTC

Job description

Salary

Starting at $18.00 / hr

Overview

Woodmark Pharmacy of NY is looking for an experienced, detail- oriented Pharmacy Billing Specialist to join our team and make a difference in the lives of our residents and their families. This position is FULL TIME ON-SITE. Candidates are expected to already reside in the area as the interview process is in person.

Benefits of working at Woodmark of NY:

• Full Benefits Package - Medical, Dental, Vision, Life
• 401(k) with company match
• Competitive Pay
• Weekly Paycheck
• Solid Team Atmosphere

Shift: Days - 8:00am - 4:00pm

Responsibilities

• Electronic billing of Medicare, Medicaid and Third Party Insurance pharmacy claims utilizing Framework LTC Pharmacy system.
• Skilled nursing facility, assisted living facility and private pay pharmacy claim billing
• Troubleshoot rejected insurance claims resulting in payments
• Prior Authorizations required from Third Party Insurance
• Bill/Invoice Review
• Medicaid Pending Status Review
• Medicaid claim rebilling
• Updated Skilled Nursing Facility Census and Resident Payer Status
• Projects as needed
• Customer Service orientated (external and internal)

Base wages increase with experience!

Qualifications

• Associate's Degree or High School diploma (or GED) and 1-2 years medical billing/collections experience (Long Term Care Preferred) or Pharmacy Technician experience in retail, long term care or hospital.
• Experience with Pharmacy claims and various types of pharmacy billing preferred
• Excellent Customer Service and Phone Skills required
• Sage 300 and Framework LTC software experience preferred
• Microsoft Office 365
• Excellent organizational and time management skills
• Self-motivated with ability to effectively solve problems

This position requires regular interaction with residents, coworkers, visitors, and/or supervisors.In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level.

EOE Statement

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.