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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