Pharmacy Billing Specialist: Insurance & Rejections

City of Lincoln; Orlando (FL); Remote; USD 35,000 - 55,000; Full time

Job summary

Specialty Rx, Inc. in Orlando seeks a dedicated Billing Specialist to support hospital/clinic billing and insurance workflows. You will process claims, verify patient eligibility, and communicate with insurers to resolve rejections.

The role emphasizes accuracy, attention to detail, and the ability to work independently as well as with a team. Flexibility to handle varied shifts is required. Experience in long-term care pharmacy and NY billing is preferred, with strong phone etiquette and a

Qualifications

• H.S. diploma or equivalent.
• Experience with third party rejections.
• Experience in Long Term Care Pharmacy preferred.
• Experience in New York Pharmacy billing claims preferred.
• Courteous and polite phone skills.
• Previous experience in pharmacy.
• Must be able to work independently and as a team.
• Ability to multitask and work in a fast-paced environment.
• Frameworks/ECM knowledge a plus.
• Must be detail oriented.

Responsibilities

• Perform duties assigned by the Billing Supervisor
• Research and establish patient eligibility coverage with insurance providers (state and private)
• Determine and process insurance rejections in accordance with the daily report
• Maintain and update patient billing and insurance information in the system
• Submit prior authorizations for State insurance
• Interact with insurance company on daily basis, i.e., overrides, rejections, and insurance updates
• Interact with client facilities staff, PDP (Medicare), CMS, NJM and NYM, if necessary
• Follow up and resolved pending billing issues

Skills

Attention to detail

Time management

Phone etiquette

Independent and team work

Education

High school diploma or equivalent

Tools

Billing software

ECM/Frameworks knowledge

Job description

Specialty Rx, Inc. in Orlando seeks a dedicated Billing Specialist to support hospital/clinic billing and insurance workflows. You will process claims, verify patient eligibility, and communicate with insurers to resolve rejections.

The role emphasizes accuracy, attention to detail, and the ability to work independently as well as with a team. Flexibility to handle varied shifts is required. Experience in long-term care pharmacy and NY billing is preferred, with strong phone etiquette and a