Medicare B Specialist

PharMerica•Lyndon, KY

2d•Remote

About The Position

The Medicare B Specialist will be responsible for research, billing, collections, and/or resolution of an assigned account portfolio in accordance with PharMerica’s policies. The position requires a high level of attention to detail when initiating, processing, and tracking prior authorizations on behalf of customers. Working closely with EMAR systems, healthcare facilities, and clinical teams, the Medicare D Biller serves as a key point of contact throughout the prior authorization process, ensuring efficient coordination, thorough documentation, and successful resolution of authorization requests.

Requirements

High School Diploma or GED
Two years billing and/or collections experience
Familiarity with standard concepts, practices, and procedures with discipline
Certified Pharmacy Technician
Strong analytical, communication, and interpersonal skills

Nice To Haves

Associate degree
Medicare B preferred

Responsibilities

Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, policies and procedures, Corporate Compliance Agreement, applicable federal and state laws, and professional standards
Investigates Medicare B eligibility such as diagnosis, place of service, and medication for payment
Prepares assignment of benefits, written orders, and obtains signatures from responsible parties
Collects refill requests and dated manifest for each dispense
Transmits electronic claim to Medicare B and after primary payment is received, prepares claim for secondary payer when applicable
Responds to Medicare payer audits
Maintains a thorough knowledge of Medicare coverage criteria, billing, coding, and documentation requirements