Pharmacy Billing Specialist — Insurance & Rejections (Flexible Hours)

City of Lincoln; Austin (TX); Remote; USD 42,000 - 62,000; Full time

Job summary

Specialty Rx, Inc. is seeking a capable Billing/Pharmacy Technician to support the claims process in a busy long-term care setting.

The role focuses on verifying patient eligibility, handling insurance rejections, updating billing data, and submitting prior authorizations. Ideal candidates have a high school diploma, experience with third-party payers, strong phone skills, and the ability to work independently or as part of a team in a fast-paced environment.

Qualifications

• H.S. diploma or equivalent is required.
• Experience with third-party rejections is required.
• Experience in Long Term Care Pharmacy preferred.
• Experience in New York Pharmacy billing claims preferred.
• Courteous and polite phone skills are essential.
• Previous experience in pharmacy is preferred.
• Must be able to work independently and as a team.
• Ability to multitask and work in a fast-paced environment is a must.
• 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 resolve pending billing issues.

Skills

H.S. diploma or equivalent

Third party rejections

Long Term Care Pharmacy experience

New York Pharmacy billing experience

Phone skills

Independent and team work

Multitasking in fast-paced environment

ECM knowledge

Attention to detail

Education

High school diploma

Job description

Specialty Rx, Inc. is seeking a capable Billing/Pharmacy Technician to support the claims process in a busy long-term care setting.

The role focuses on verifying patient eligibility, handling insurance rejections, updating billing data, and submitting prior authorizations. Ideal candidates have a high school diploma, experience with third-party payers, strong phone skills, and the ability to work independently or as part of a team in a fast-paced environment.