Pharmacy Billing Representative

Westminster Brand 051816•Orlando, FL

About The Position

Longevity Scripts is seeking a full-time Pharmacy Billing Representative for its Orlando location. The role provides guidance on Medicare, Medicaid, Prescription Drug Plans (PDPs), and third-party insurance to appropriate health care professionals. It also advises residents and appropriate parties on available PDP options and enrolls residents in, and applies for, low-income subsidies when applicable. The position supports billing for assigned customers, insurance-claim resolution, resident profile maintenance, and related pharmacy operations.

Requirements

High school diploma or equivalent.
Proficiency in Microsoft Word and Excel.
One to three years of long-term-care pharmacy billing experience.
One to three 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 with business partners and stakeholders regarding Medicare Part D coverage and PDPs.
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 in and apply for low-income subsidies when applicable.