Pharmacy Billing Specialist
On-siteBuffalo, New York, United States
Buffalo, New York, United StatesOn-siteFull TimeAssociates DegreeLarge
Full TimeAssociates DegreeLarge
Job Summary
Conduct electronic billing of Medicare, Medicaid, and third-party insurance pharmacy claims using the Framework LTC Pharmacy system. Troubleshoot rejected insurance claims to ensure payments and manage prior authorizations. Review bill/invoices, monitor Medicaid pending status, and handle claim rebilling. Update skilled nursing facility census and resident payer status. Provide customer service to external and internal stakeholders. This full-time on-site role supports Woodmark Pharmacy of NY's residents and families.
Required Qualifications
- Associate's Degree or High School diploma (or GED)
- 1-2 years medical billing/collections experience
- 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
- Long Term Care experience
- 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
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