Processes Medicare, Medicaid, third-party insurance, skilled nursing facility, assisted living, and private-pay pharmacy claims. Troubleshoots rejected claims, handles prior authorizations and rebilling, reviews invoices, monitors Medicaid-pending accounts, updates census and payer information, and provides internal and external customer service. The role also supports collections, claim reconciliation, and related projects while maintaining accurate records and resolving billing issues.
SalaryStarting at $18.00 / hr
Overview
Responsibilities
Woodmark Pharmacy of NY is looking for an experienced, detail- oriented Pharmacy Billing Specialist to join our team and make a difference in the lives of our residents and their families. This position is Full Time on-site!
Benefits of working at Woodmark of NY:
- Full Benefits Package - Medical, Dental, Vision, Life
- 401(k) with company match
- Competitive Pay
- Weekly Paycheck
- Solid Team Atmosphere - position is on-site!
Shift: Days - 8:00am - 4:00pm
Responsibilities
- Electronic billing of Medicare, Medicaid and Third Party Insurance pharmacy claims utilizing Framework LTC Pharmacy system.
- Skilled nursing facility, assisted living facility and private pay pharmacy claim billing
- Troubleshoot rejected insurance claims resulting in payments
- Prior Authorizations required from Third Party Insurance
- Bill/Invoice Review
- Medicaid Pending Status Review
- Medicaid claim rebilling
- Updated Skilled Nursing Facility Census and Resident Payer Status
- Projects as needed
- Customer Service orientated (external and internal)
Base wages increase with experience!
FromUp toQualifications- Associate's Degree or High School diploma (or GED) and 1-2 years medical billing/collections experience (Long Term Care Preferred) or Pharmacy Technician experience in retail, long term care or hospital.
- Experience with Pharmacy claims and various types of pharmacy billing preferred
- Excellent Customer Service and Phone Skills required
- Collections experience preferred
- Sage 300 and Framework LTC software experience preferred
- Microsoft Office 365
- Excellent organizational and time management skills
- Self-motivated with ability to effectively solve problems
This position requires regular interaction with residents, coworkers, visitors, and/or supervisors. In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level.
EOE StatementWE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.Similar Jobs
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