Pharmacy Billing Supervisor

Westminster Communities of Florida; Orlando (FL); On-site; USD 60,000 - 75,000; Full time

Job summary

JobRx, Inc. is seeking a Pharmacy Billing Supervisor in Orlando, FL. The position involves supervising billing staff and managing claims for pharmacy services, ensuring compliance with Medicare and Medicaid regulations.

Qualified candidates should have 3–5 years of experience in long-term care billing with strong knowledge of pharmacy operations. Excellent communication skills and proficiency in billing software are essential to manage effectively in a fast-paced environment.

Qualifications

• 3–5 years LTC business office experience required.
• Working knowledge of third-party claim adjudication processes.
• Experience resolving insurance claim rejections and denials preferred.
• Strong problem-solving and critical-thinking abilities.

Responsibilities

• Supervise billing office staff in daily operations of pharmacy services.
• Manage submittal of claims with third-party insurance.
• Ensure reconciliation of third-party claims and cash collections.
• Educate staff on proper processes and procedures.

Skills

Knowledge of Medicare Part D

Strong organizational skills

Excellent verbal and written communication skills

Proficiency in Microsoft Office Suite

Problem-solving abilities

Education

3–5 years LTC business office experience

Tools

Pharmacy management and billing software systems

NetRx

Sage 300

Job description

Longevity Scripts is seeking to fill a Pharmacy Billing Supervisor position at our pharmacy located in Orlando, FL. This position is responsible for supervising billing office staff in the daily operations of admissions, billing, and adjudication of pharmacy services, as well as overseeing the reconciliation of account receivables and developing methodology for prompt payment.

EOE/DFWP – We honor those who serve.

Scope of Responsibilities/Accountability

• Direct billing office staff in processing pharmacy services claims in accordance with internal policies, federal and state laws, applicable professional standards, and pharmacy service contracts.
• Maintain confidentiality of all patient and/or employee information to protect rights.
• Manage submittal of claims with third‑party insurance, private pay residents, workers’ compensation, facility Medicare Part A, managed care charges (including outlier charges), and house stock charges.
• Provide leadership and guidance to billing staff on positively handling billing inquiries from sponsors or other responsible parties.
• Ensure reconciliation of third‑party claims.
• Work with Pharmacy Controller to provide statistical revenue information and develop strategies for maximizing gross margins.
• Oversee and coordinate billing office team members in daily billing, credits, and remittances from third‑party plans.
• Maintain gaining reports and timely cash collections.
• Perform all month‑end processes to ensure accurate and timely recording of monthly revenues.
• Work closely with Westminster Communities to provide all documentation necessary for accurate monthly pharmacy invoicing.
• Process daily remittances through designated software systems (e.g., NetRx, Sage 300, MHA, Inc.).
• Manage and maintain accurate electronic records for all pharmacy receivables.
• Resolve rejections, denials, and prior authorizations associated with third‑party insurance claims (e.g., PDPs, Medicaid).
• Educate staff on proper processes and procedures to coordinate workflow.
• Participate in the hiring process and coordinate orientation and training of the billing staff.
• Interact frequently with facilities, physicians, and other pharmacy team members at all levels, promoting teamwork and demonstrating strong leadership skills and professionalism.
• Verify and clarify any and all problems or inquiries with facility documentation requests/needs.
• Utilize reference materials to improve skills regularly, including training and continuing education.
• Promote customer service and enhance brand image to support the overall organizational mission.
• Perform various pharmacy office duties as determined by the Pharmacy Controller.
• In the absence of the Pharmacy Controller, stand in as interim Controller.

Essential Qualifications

• 3–5 years LTC business office experience required.
• Working knowledge of Medicare Part D, Medicaid, managed care plans, commercial insurance, and third‑party claim adjudication processes.
• Experience resolving insurance claim rejections, denials, and prior authorization issues preferred.
• Knowledge of long‑term care pharmacy operations and nursing facility workflows preferred.
• Experience with pharmacy management and billing software systems preferred (e.g., Frameworks LTC).
• Proficiency in Microsoft Office Suite, including Word, Excel, and Outlook.
• Strong organizational skills with the ability to manage multiple priorities in a fast‑paced environment.
• Excellent verbal and written communication skills.
• Strong problem‑solving and critical‑thinking abilities.
• Ability to maintain confidentiality and comply with HIPAA requirements.

Applicants can learn more about Florida background screening requirements at https://info.flclearinghouse.com/

Equal Opportunity Employer.

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.