Pharmacy Billing Specialist - LTC Claims & Reconciliation

Nexus HR; Sacramento (CA); Presencial; USD 25 000 - 30 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Dental, Vision, and Health Insurance

PTO and Sick Leave

401k

Resumo da oferta

Nexus HR is seeking a Pharmacy Billing Clerk in Sacramento, CA to manage billing operations in a fast-paced long-term care and assisted living pharmacy.

Responsibilities include submitting insurance claims, posting payments, balancing accounts, and communicating with patients and facility staff. Requires 1 year of pharmacy billing experience, HS diploma, and proficiency with IPS, QS1, and Microsoft Office; strong data-entry and reconciliation skills are essential.

Qualificações

• High school diploma or equivalent; Associate degree preferred.
• Minimum 1 year of pharmacy billing experience.
• In-depth knowledge of insurance requirements.
• Proficiency in IPS, QS1, and Microsoft Suite; or comparable software/s.
• Excellent analytical, organizational, and problem-solving skills.
• Strong communication with healthcare providers and facility staff.
• High attention to detail and accuracy in data entry and financial reconciliation.

Responsabilidades

• Accurately prepare, submit, and track insurance claims for medications dispensed to long-term care and institutional patients.
• Verify insurance eligibility, prepare and submit claims, and post payments accurately.
• Generate statements of accounts and follow up on unpaid balances with patients and facility staff.
• Handle billing inquiries, explain charges, and collect payments professionally.
• Resolve denied claims by coordinating with insurance providers or PBMs.
• Maintain accurate billing records and prepare reports as needed.
• Perform general administrative tasks, including MS Word & Excel, email correspondence, and managing office supplies.

Conhecimentos

Analytical skills

Organizational skills

Problem solving

Communication

Attention to detail

Data entry

Formação académica

Associate degree in healthcare administration

High school diploma or equivalent

Ferramentas

IPS - Intelligent Pharmacy Software

QS1

Microsoft Office

Descrição da oferta de emprego

Nexus HR is seeking a Pharmacy Billing Clerk in Sacramento, CA to manage billing operations in a fast-paced long-term care and assisted living pharmacy.

Responsibilities include submitting insurance claims, posting payments, balancing accounts, and communicating with patients and facility staff. Requires 1 year of pharmacy billing experience, HS diploma, and proficiency with IPS, QS1, and Microsoft Office; strong data-entry and reconciliation skills are essential.