Remote Billing Representative - Third Party

SpecialtyRx • Ridgefield Park, NJ

5d • Hybrid

About The Position

SpecialtyRx is a full-service pharmacy seeking a Remote Billing Representative with Third Party Rejections experience. This role is based out of our Ridgefield Park, NJ location. The ideal candidate will have experience with LTC Pharmacy Third Party Billing Rejections. The company offers flexible hours, including shifts from 8am-4pm, 9am-5pm, 11am-7pm, 12pm-8pm, 3pm-11pm, and 4pm-12am. A mandatory three-week onsite training period is required.

Requirements

• H.S. diploma or equivalent.
• Courteous and polite phone skills.
• Computer literate.
• Ability to work nights and weekends.
• Previous experience in Retail pharmacy is a must.
• Previous experience in Third Party Rejections Billing is a must.
• Must be able to work independently and as a team.
• The ability to multitask and work in a fast-paced environment is a must.
• Must be detail-oriented.

Nice To Haves

• Experience in Long Term Care Pharmacy.
• Experience in New York Pharmacy billing claims.
• Frameworks/ECM knowledge is a plus.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED