Remote Pharmacy Billing Specialist (Hybrid) - Medicare

CommuniCare Health; Northern (KY); Hybrid; USD 29,000 - 32,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) with company match

Paid time off

Job summary

CommuniCare Health is seeking a Pharmacy Billing Specialist to manage patient accounts and ensure accurate billing across payers. You will verify insurance details, work with Medicare Part D and managed care, and collaborate with multiple facilities to resolve census clarifications.

The role emphasizes adherence to HIPAA guidelines, ongoing review of billing reports, and collaboration with hospice and third-party plans to maintain compliant, timely invoicing.

Qualifications

• Must follow billing processes per manual for consistency and compliance.
• Experience with Medicare Part D, Medicaid and managed care plans is preferred.
• Knowledge of HIPAA guidelines and patient privacy requirements.

Responsibilities

• Follow all billing processes as outlined to ensure consistency and prescription integrity.
• Maintain and update patient accounts by verifying or editing current insurance details.
• Collaborate with facility business office managers for Medicare Part D plans and census clarifications.
• Work with hospice and third-party plans as needed.
• Review SQL reports daily to ensure clean facility invoices.
• Perform other billing-related duties as assigned.
• Adhere to federal and state regulations and company policies.

Skills

Billing processes

Insurance verification

Medicare Part D

Medicaid

Commercial insurance

HIPAA compliance

SQL reports

Long-Term Care pharmacy experience

Attention to detail

Tools

SQL

Framework LTC

Job description

CommuniCare Health is seeking a Pharmacy Billing Specialist to manage patient accounts and ensure accurate billing across payers. You will verify insurance details, work with Medicare Part D and managed care, and collaborate with multiple facilities to resolve census clarifications.

The role emphasizes adherence to HIPAA guidelines, ongoing review of billing reports, and collaboration with hospice and third-party plans to maintain compliant, timely invoicing.