Pharmacy Billing Specialist
$37,440–$37,440 year
On-siteBuffalo, New York, United States
Job Summary
Conduct electronic billing for Medicare, Medicaid, and third-party insurance pharmacy claims using the Framework LTC Pharmacy system. Troubleshoot rejected insurance claims to ensure timely payments and manage prior authorizations. Review bill/invoices and Medicaid pending statuses while updating skilled nursing facility census and resident payer information. Handle Medicaid claim rebilling and manage projects as needed. Provide customer service to external and internal stakeholders. Requires experience with pharmacy claims, Sage 300, and Framework LTC software. Full-time on-site role with days shift from 8:00am to 4:00pm.
Required Qualifications
- Associate's Degree or High School diploma (or GED)
- 1-2 years medical billing/collections experience (Long Term Care Preferred)
- Pharmacy Technician experience in retail, long term care or hospital
- Excellent Customer Service and Phone Skills
- Self-motivated with ability to effectively solve problems
- Ability to read, write, speak, and understand the English language at an intermediate or more advanced level
Desired Qualifications
- Experience with Pharmacy claims and various types of pharmacy billing
- Collections experience
- Sage 300 and Framework LTC software experience
- Microsoft Office 365
- Excellent organizational and time management skills
- Long Term Care experience
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