Pharmacy Billing Specialist

CommuniCare Health ServicesPharmacy Solutions Group West Virginia, WV
$21 - $23Hybrid

About The Position

Manage and update patient accounts to ensure consistent billing processes for all payers as outlined in the billing manual. This role involves maintaining current patient accounts by verifying, adding, or editing insurance information (Medicare Part D, Commercial, Medicaid, Medicare A, and Managed Care). The specialist will collaborate with facility business office managers for Medicare Part D insurance plans and census clarifications, and work directly with hospice and third-party plans as needed. Daily reviews of SQL reports are required to ensure clean facility invoices. The position also includes following federal and state regulations, adhering to company policies and procedures, and complying with HIPPA guidelines.

Requirements

  • Knowledge of Framework LTC a plus (but not required)
  • Previous Long-Term Care pharmacy experience a plus (but not required)

Responsibilities

  • Follow all billing processes as outlined in the billing manual to ensure consistency and prescription integrity for compliance.
  • Maintain all current patient accounts by verifying, adding or editing current insurance (Medicare Part D, Commercial, Medicaid, Medicare A and Managed Care).
  • Works closely with the facility business office managers for Medicare Part D insurance plans and Census clarifications.
  • Works directly with several hospice plans and third party plans as needed.
  • Daily reviews of SQL reports setup to ensure a clean facility invoice.
  • Any other assigned duties that relates to billing.
  • Follow federal and state regulations.
  • Adhere to company policies and procedures.
  • Follow HIPPA guidelines and regulations.

Benefits

  • health insurance
  • dental insurance
  • vision insurance
  • 401(k) with company match
  • paid time off
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