Remote Pharmacy Billing Manager – Revenue Ops Lead

OHE OHNH EMP LLC; Kentucky; Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) with company match

Paid time off

Job summary

CommuniCare Family of Companies is hiring a Billing Manager to oversee the day-to-day operation of the billing unit for each pharmacy. You will manage and update patient accounts to ensure consistent billing processes for all payers as outlined in the billing manual.

This role also leads the pharmacy credentialing process for PBM insurers across PSG locations, ensures ongoing credentialing, and ensures compliance with HIPAA, state and federal regulations.

Qualifications

• Experience managing a billing team in a pharmacy setting.
• Familiar with Medicare Part D, Medicaid and commercial payer processes.
• Knowledge of LTC billing workflows and credentialing.
• Ability to ensure compliance with HIPAA and billing policies.

Responsibilities

• Oversee day-to-day billing operations for multiple pharmacies.
• Maintain and update patient accounts across payers.
• Coordinate PBM credentialing and re-credentialing.
• Ensure billing accuracy and adherence to the billing manual.
• Collaborate with facility managers and third-party plans as needed.
• Ensure compliance with HIPAA and state/federal regulations.
• Provide leadership and cross-functional support.

Skills

Team leadership

Long-Term Care pharmacy experience

LTC framework knowledge

Pharmacy payer credentialing

Job description

CommuniCare Family of Companies is hiring a Billing Manager to oversee the day-to-day operation of the billing unit for each pharmacy. You will manage and update patient accounts to ensure consistent billing processes for all payers as outlined in the billing manual.

This role also leads the pharmacy credentialing process for PBM insurers across PSG locations, ensures ongoing credentialing, and ensures compliance with HIPAA, state and federal regulations.