Pharmacy Billing Specialist

CommuniCare Health Services • Maryland, NY

2d • Hybrid

About The Position

Manage and update patient accounts to ensure consistent billing processes for all payers as outlined in the billing manual. This role is crucial for maintaining the integrity of prescription billing and ensuring compliance with federal and state regulations. The specialist will work with various insurance types and collaborate with facility business office managers and third-party plans. Daily reviews of SQL reports are required to ensure clean facility invoices. The company, CommuniCare Family of Companies, has been committed to delivering exceptional person-centered care since 1984, operating over 150 facilities across six states and employing over 19,000 people.

Requirements

• Knowledge of Framework LTC a plus (but not required)
• 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

• Manage and update patient accounts to ensure consistent billing processes for all payers as outlined in the billing manual.
• 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.
• Follow all billing processes as outlined in the billing manual to ensure consistency and prescription integrity for compliance.
• Follow federal and state regulations.
• Adhere to company policies and procedures.
• Follow HIPPA guidelines and regulations.
• Any other assigned duties that relates to billing.

Benefits

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed