Remote Billing Specialist: Third-Party Rejections (LTC)

SpecialtyRx, Inc; Ridgefield Park (NJ); On-site; USD 42,000 - 54,000; Full time

Job summary

SpecialtyRx, Inc. is seeking a Remote Billing Representative with Third Party Rejections experience for our Ridgefield Park, NJ location. The role focuses on managing third-party billing rejections, patient eligibility with insurers, and daily reporting.

Responsibilities include coordinating with insurance providers, updating billing data, and submitting prior authorizations for state plans. Must have prior retail pharmacy billing and LTC experience, and be able to work nights and weekends.

Qualifications

• High school diploma or equivalent.
• Must have experience in Retail pharmacy and third party rejections billing.
• Experience with Long Term Care Pharmacy billing preferred.
• Ability to work nights and weekends.
• Must be detailed and able to multitask in a fast-paced environment.
• Experience with New York pharmacy billing (preferred).

Responsibilities

• Perform duties assigned by the Billing Supervisor.
• Research and establish patient eligibility coverage with insurance providers (state and private).
• Determine and process insurance rejections by the daily report.
• Maintain and update patient billing and insurance information in the system.
• Submit prior authorizations for State insurance.
• Interact with the insurance company on daily basis regarding overrides, rejections, and insurance updates.
• Interact with client facilities staff, PDP (Medicare), CMS, NJM, and NYM when necessary.
• Follow up and resolved pending billing issues.

Skills

Phone communication

Attention to detail

Multitasking

Independent and team player

Third party billing experience

Education

High School diploma or equivalent

Tools

Billing software familiarity

Job description

SpecialtyRx, Inc. is seeking a Remote Billing Representative with Third Party Rejections experience for our Ridgefield Park, NJ location. The role focuses on managing third-party billing rejections, patient eligibility with insurers, and daily reporting.

Responsibilities include coordinating with insurance providers, updating billing data, and submitting prior authorizations for state plans. Must have prior retail pharmacy billing and LTC experience, and be able to work nights and weekends.