Pharmacy Billing Specialist
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 for various payers including 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 requires adherence to federal and state regulations, company policies, and HIPAA guidelines.
Requirements
- Manage and update patient accounts to ensure consistent billing processes for all payers.
- Maintain current patient accounts by verifying, adding or editing current insurance (Medicare Part D, Commercial, Medicaid, Medicare A and Managed Care).
- Work closely with facility business office managers for Medicare Part D insurance plans and Census clarifications.
- Work directly with several hospice plans and third party plans as needed.
- Daily reviews of SQL reports setup to ensure a clean facility invoice.
- Follow federal and state regulations.
- Adhere to company policies and procedures.
- Follow HIPPA guidelines and regulations.
Nice To Haves
- Previous Long-Term Care pharmacy experience a plus
- Knowledge of Framework LTC a plus
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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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
