Pharmacy Billing Specialist
About The Position
Woodmark Pharmacy of NY is seeking an experienced, detail-oriented Pharmacy Billing Specialist to support residents and their families. This is a full-time, on-site position; candidates are expected to reside in the area, and interviews are conducted in person. The schedule is a day shift from 8:00 a.m. to 4:00 p.m. Starting pay is $18.00 per hour, with base wages increasing based on experience. The role handles pharmacy claim billing for Medicare, Medicaid, third-party insurance, skilled nursing facilities, assisted living facilities, and private-pay residents. It also involves resolving rejected claims, obtaining prior authorizations, reviewing billing and invoices, and maintaining payer-status and facility census information. The position requires customer-service interactions with internal and external contacts and regular communication in English with residents, coworkers, visitors, and supervisors.
Requirements
- Associate degree, or high school diploma/GED and 1–2 years of medical billing or collections experience; long-term care experience is preferred, or pharmacy technician experience in retail, long-term care, or a hospital.
- Excellent customer service and phone skills.
- Microsoft Office 365 skills.
- Excellent organizational and time-management skills.
- Self-motivated, with the ability to solve problems effectively.
- Ability to read, write, speak, and understand English at an intermediate or more advanced level.
- Expected to reside in the area; the interview process is in person.
Nice To Haves
- Experience with pharmacy claims and various types of pharmacy billing.
- Experience with Sage 300 and Framework LTC software.
- Long-term care experience in medical billing or collections.
Responsibilities
- Electronically bill Medicare, Medicaid, and third-party insurance pharmacy claims using the Framework LTC Pharmacy system.
- Bill pharmacy claims for skilled nursing facilities, assisted living facilities, and private-pay residents.
- Troubleshoot rejected insurance claims to secure payment.
- Obtain prior authorizations required by third-party insurance.
- Review bills and invoices.
- Review Medicaid-pending status.
- Rebill Medicaid claims.
- Keep skilled nursing facility census and resident payer-status information updated.
- Complete projects as needed.
- Provide customer service to external and internal contacts.
Benefits
- Medical, dental, vision, and life insurance benefits.
- 401(k) with company match.
- Competitive pay.
- Weekly paycheck.
- Solid team atmosphere.
- Base wages increase with experience.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
