Pharmacy Billing Specialist

Woodmark•Buffalo, NY

7d•Onsite

About The Position

Woodmark Pharmacy of NY is seeking an experienced, detail-oriented Pharmacy Billing Specialist to support pharmacy billing for residents and their families. This is a full-time, on-site position with a day shift from 8:00 a.m. to 4:00 p.m. Candidates are expected to reside in the area because interviews are conducted in person. The role includes electronic pharmacy claims billing, insurance-claim troubleshooting, billing reviews, and customer service. Base wages increase with experience.

Requirements

Associate degree, or high school diploma or GED and 1–2 years of medical billing or collections experience; long-term-care experience is preferred. Pharmacy Technician experience in retail, long-term care, or a hospital is also accepted.
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.

Nice To Haves

Experience with long-term-care medical billing or collections.
Experience with pharmacy claims and different types of pharmacy billing.
Sage 300 and Framework LTC software experience.

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 obtain payment.
Obtain prior authorizations required by third-party insurance.
Review bills and invoices.
Review Medicaid-pending status.
Rebill Medicaid claims.
Maintain updated skilled nursing facility census and resident payer status.
Complete projects as needed.
Provide customer service to external and internal customers.