Pharmacy Billing Supervisor: Lead Claims & Cashflow

WESTMINSTER SENIOR CARE PHARMACY; Orlando (FL); On-site; USD 60,000 - 85,000; Full time

Job summary

Longevity Scripts in Orlando, FL seeks a Pharmacy Billing Supervisor to oversee daily billing operations for pharmacy services, admissions, and adjudication. You will supervise billing office staff, ensure timely payments, and reconcile accounts receivable in coordination with the Pharmacy Controller.

The role requires experience with Medicare Part D, Medicaid, and third-party claims, strong organization and communication skills, and compliance with HIPAA. This is an Equal Opportunity Employer.

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 billing software systems preferred (e.g., Frameworks LTC).
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Strong organizational skills and ability to manage multiple priorities in a fast-paced environment.
• Excellent verbal and written communication skills.
• Ability to maintain confidentiality and comply with HIPAA requirements.

Responsibilities

• Directs billing office staff in processing pharmacy services claims in accordance with internal policies and procedures and applicable laws.
• Maintains confidentiality of patient and employee information.
• Manages submission of claims with third party insurance, private pay residents, workers compensation, facility Medicare Part A and Managed Care charges.
• Provides leadership to billing staff regarding handling billing inquiries from sponsors or other responsible parties.
• Ensures reconciliation of third-party claims.
• Works with Pharmacy Controller to provide revenue information and develop strategies for maximizing gross margins.
• Oversees and coordinates billing office team in daily billing, credits, and remittances from third party plans.
• Maintains gain reports and timely cash collections.
• Performs month-end processes to ensure revenues are recorded accurately and timely.
• Collaborates with Westminster Communities for monthly pharmacy invoicing documentation.
• Responsible for daily remittance processing through NetRx, Sage 300, MHA, Inc.
• Maintains electronic records for all pharmacy receivables.
• Resolves rejections, denials, and prior authorizations for third-party claims.
• Educates staff on workflows and processes; coordinates hiring and training of billing staff.
• Interacts with facilities, physicians, and pharmacy team members; promotes teamwork and professionalism.
• Verifies and clarifies problems or inquiries with facility documentation requests/needs.
• Uses reference materials for ongoing training and education.
• Promotes customer service and brand image to support organizational mission.
• Handles various pharmacy office duties as assigned by Pharmacy Controller.
• In the absence of Pharmacy Controller, may serve as interim Controller.

Skills

Organizational skills

Verbal and written communication

Problem-solving

HIPAA compliance

Microsoft Office

Billing workflows

Tools

NetRx

Sage 300

Frameworks LTC

Job description

Longevity Scripts in Orlando, FL seeks a Pharmacy Billing Supervisor to oversee daily billing operations for pharmacy services, admissions, and adjudication. You will supervise billing office staff, ensure timely payments, and reconcile accounts receivable in coordination with the Pharmacy Controller.

The role requires experience with Medicare Part D, Medicaid, and third-party claims, strong organization and communication skills, and compliance with HIPAA. This is an Equal Opportunity Employer.