Pharmacy Billing Specialist - LTC Claims & Reimbursements

Woodmark Pharmacy Inc.; Buffalo (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

Competitive Pay

Weekly Paycheck

Solid Team Atmosphere

Job summary

Woodmark Pharmacy of NY is seeking an experienced Pharmacy Billing Specialist to join our team. This full-time on-site role requires in-person interviews and a strong background in medical billing for long-term care facilities.

Responsibilities include electronic billing of Medicare/Medicaid and third-party claims, handling facility billing, solving rejected claims, and maintaining accurate census and payer status. Competitive benefits and weekly pay included.

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

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)

Skills

Customer service

Phone skills

Time management

Problem solving

Education

Associate's Degree or High School diploma (or GED)

Tools

Sage 300

Framework LTC

Microsoft Office 365

Job description

Woodmark Pharmacy of NY is seeking an experienced Pharmacy Billing Specialist to join our team. This full-time on-site role requires in-person interviews and a strong background in medical billing for long-term care facilities.

Responsibilities include electronic billing of Medicare/Medicaid and third-party claims, handling facility billing, solving rejected claims, and maintaining accurate census and payer status. Competitive benefits and weekly pay included.