Pharmacy Billing Representative

Westminster Communities of Florida•Orlando, FL

10d•Onsite

About The Position

Longevity Scripts is seeking a full-time Pharmacy Billing Representative for its Orlando location. The position provides knowledge of Medicare, Medicaid, Prescription Drug Plans (PDPs), and third-party insurance to appropriate health care professionals. The representative advises residents and appropriate parties on available PDP options and enrolls residents and applies for low-income subsidies when applicable. The role handles billing for assigned customers, resolves third-party insurance claim rejections, denials, and prior authorizations, and serves as a communication liaison regarding Medicare Part D coverage and PDPs. It also supports staff education, resident profile maintenance, reporting, incoming calls, and data entry as needed.

Requirements

High school diploma or equivalent.
Proficiency in Microsoft Word and Excel.
1–3 years of long-term care pharmacy billing experience.
1–3 years of experience with Frameworks.
Strong organizational skills, including the ability to prioritize and manage multiple tasks in a dynamic environment.
Problem-solving and critical-thinking skills.
Knowledge of Medicare, Medicaid, Prescription Drug Plans (PDPs), and third-party insurance.
Knowledge of pharmacy computer software and the ability to process medication orders.

Responsibilities

Resolve rejections, denials, and prior authorizations associated with third-party insurance claims, including PDPs and Medicaid.
Serve as a communication liaison regarding Medicare Part D coverage and PDPs with business partners and stakeholders.
Educate staff on proper prior authorization processes.
Maintain accurate resident profiles.
Answer incoming calls.
Advise residents and appropriate parties on available PDP options.
Prepare reports as requested by management, customers, and residents.
Provide data entry support as needed.
Handle billing responsibilities for assigned customers.
Enroll residents and apply for low-income subsidies when applicable.