Pharmacy Billing Specialist – Medicare & PDPs Expert

Westminster Communities of Florida; Orlando (FL); On-site; USD 42,000 - 60,000; Full time

Job summary

Westminster Pharmacy Services in Orlando, FL is seeking a full-time Pharmacy Billing Representative to manage Medicare, Medicaid, PDPs and third-party insurances. You will resolve rejections/denials, advise on PDP options, and support billing for assigned accounts.

The ideal candidate has 1–3 years LTC pharmacy billing experience, proficiency in Word and Excel, and strong organizational and problem-solving skills to handle multiple tasks in a fast-paced environment.

Qualifications

• High School Diploma or equivalent; proficiency in Word and Excel.
• 1–3 years LTC Pharmacy billing experience.
• 1–3 years' experience with Frameworks.
• Ability to prioritize and manage multiple tasks in a dynamic environment; strong problem-solving skills.
• Knowledge of Medicare, Medicaid, PDPs and Third-Party Insurances; familiarity with pharmacy software.

Responsibilities

• Resolve rejections, denials, and PAs for third-party insurance claims (PDPs, Medicaid).
• Communicate PDP coverage details with partners and stakeholders.
• Educate staff on PA processes; maintain resident profiles.
• Answer incoming calls.
• Advise residents on PDP options available.
• Prepare reports for management, customers and residents.
• Data entry support as needed.
• Billing responsibilities for assigned customers.

Skills

Strong organizational skills

Problem solving & critical thinking

Multitasking in dynamic environment

Communicate with healthcare partners

Education

High School Diploma or equivalent

Tools

Word

Excel

Job description

Westminster Pharmacy Services in Orlando, FL is seeking a full-time Pharmacy Billing Representative to manage Medicare, Medicaid, PDPs and third-party insurances. You will resolve rejections/denials, advise on PDP options, and support billing for assigned accounts.

The ideal candidate has 1–3 years LTC pharmacy billing experience, proficiency in Word and Excel, and strong organizational and problem-solving skills to handle multiple tasks in a fast-paced environment.