Manage and update patient accounts, verify and edit insurance (Medicare Part D, Commercial, Medicaid, Medicare A, Managed Care), liaise with facility business offices and hospice/third-party plans, review SQL reports daily to ensure clean invoices, follow billing manual and federal/state regulations, and maintain HIPAA compliance.
Job Address:
15063 MacCorkle Avenue Cabin Creek, WV 25035Job Description: Pharmacy Billing Specialist
Reports to: Pharmacy Billing Supervisor
Job Type: Full-Time – Hybrid/Remote – Pharmacies: West Virginia, Ohio, Indiana and Maryland
Pay Rate: $21-23/hr
Position Overview:
Manage and update patient accounts to ensure consistent billing processes for all payers as outlined in the billing manual.
Key Responsibilities:
- Follow all billing processes as outline 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
Qualifications:
- Previous Long-Term Care pharmacy experience a plus (but not required)
- Knowledge of Framework LTC a plus (but not required)
Salary and Benefits:
- Competitive salary commensurate with experience
- Comprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more
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Manage and update patient pharmacy accounts to ensure accurate billing across payers. Verify and edit insurance (Medicare Part D, Medicare A, Medicaid, commercial, managed care), review SQL reports for clean facility invoices, coordinate with business office managers and hospice/third-party plans, and maintain compliance with federal/state regulations and HIPPA guidelines.
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