Pharmacy Billing Specialist

Woodmark Pharmacy; New York, Buffalo (NY, NY); On-site; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented Pharmacy Billing Specialist to join their dedicated team. This role involves managing electronic billing for Medicare, Medicaid, and Third Party Insurance claims, ensuring accuracy and efficiency. With a strong emphasis on customer service, you'll be part of a supportive work environment that values your contributions. Enjoy a competitive starting pay rate with opportunities for growth based on experience. Join a company that prioritizes the well-being of its residents and fosters a collaborative atmosphere.

Benefits

Full Benefits Package - Medical, Dental, Vision, Life

401(k) with company match

Competitive Pay

Weekly Paycheck

Solid Team Atmosphere

Qualifications

• 1-2 years medical billing/collections experience preferred.
• Experience with pharmacy claims and billing is a plus.

Responsibilities

• Responsible for electronic billing of Medicare, Medicaid, and Third Party Insurance claims.
• Troubleshoot rejected insurance claims and process private pay refunds.

Skills

Medical Billing

Customer Service

Collections

Problem Solving

Time Management

Education

Associate's Degree

High School diploma or GED

Tools

Framework LTC

Sage (ACCPAC)

Microsoft Office

Job description

Pharmacy Billing Specialist

Requisition ID

2025-32099

# of Openings

5

Area of Interest

Pharmacy

Location

Woodmark Pharmacy of New York

Position Type

Regular Full-Time

Shift

Days

Salary

Starting at $18.00 / hour

Salary

Starting at $18.00 / hour

Overview

Pharmacy Billing Specialist Starting Pay Rate : $18.00 / hour. Earn more based on Experience!

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 on-site!

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 - position is on-site!

Pharmacy Billing Specialist Position Overview:

The Pharmacy Billing Specialist is responsible for electronic billing of Medicare, Medicaid and Third Party Insurance claims, utilizing Frameworks LTC Pharmacy system. This position also is responsible for Skilled Nursing Facility, Assisted Living Facility and Private pay billing.

Shift: Days - 8a.m.- 4 p.m. or 9a.m.-5p.m.

#Talroo

Responsibilities

Pharmacy Billing Specialist Responsibilities:

• Electronic billing of Medicare, Medicaid and Third Party Insurance claims utilizing Framework LTC Pharmacy system.
• Skilled Nursing Facility, Assisted Living Facility and Private pay claim billing
• Troubleshoot rejected insurance claims resulting in payments
• Prior Authorizations required from Third Party Insurance
• Bill/Invoice Review
• Medicaid Pending Status Review
• Updated Skilled Nursing Facility Census and Resident Payer Status
• Process Private Pay refunds
• Collections on accounts
• Daily cash deposit and posting
• Third Party (835) downloading of remits into system
• Process Credits/Returns
• Projects as needed
• Customer Service orientated (external and internal)

Base wages increase with experience!

Qualifications

Pharmacy Billing Specialist 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
• Collections experience preferred
• Sage (ACCPAC), NET Rx and Framework LTC software experience preferred
• Microsoft Office proficiency (Excel, Work and Outlook)
• 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.