What are the responsibilities and job description for the Pharmacy Billing Specialist position at Premier Pharmacy Group?
Premier Pharmacy Group is looking for a Billing Specialist who is interested in becoming part of a dedicated team! Our employees are considered essential workers, and we are looking for someone who wants to make a difference in patient care.
Responsibilities
- Electronic billing of Medicare, Medicaid, and Third Party insurance claims utilizing Framework LTC Pharmacy system for residents in nursing homes. SNF, ALF, and Private pay claims.
- Work live claim adjudication
- Troubleshoot rejected insurance claims resulting in payment.
- Initiate prior authorizations required by third-party insurance
- Manage census from assigned facilities - PCC experience is a plus
- Review weekly pre-billing reports and make necessary corrections
- Provide price quotes as requested from facilities
- Contact insurance companies for disputes, verification of coverage, questions
- Work in collaboration with the pharmacy team to address any questions that arise regarding billing
Qualifications:
- Must be able to navigate through Medicare, Medicaid, and Insurance websites as well as the pharmacy system and the EMR systems at the nursing facilities (strong computer navigation skills)
- Excellent customer service skills both internal and external
· Knowledge of Prior Authorizations
- Experience with FrameworkLTC software (strongly preferred)
· Knowledge of adjudication process for LTC pharmacy is required
· Knowledge of federal and state pharmacy laws and guidelines
· Self-motivated and able to work independently
· 1 to 3 years of LTC pharmacy experience required
· Pharmacy Technician License required
- COVID19 vaccination required.
· Ability to work weekends/holidays
Work Remotely
- No
Job Types: Full-time, Part-time
Pay: $18.00 - $25.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Weekend availability
Work Location: One location