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Pharmacy Billing Specialist

Elderwood - Pediatric Specialty Care - Woodmark...
Buffalo, NY Full Time
POSTED ON 1/30/2025
AVAILABLE BEFORE 3/30/2025
Salary: Starting at $18.00 / hour Overview:
Pharmacy Billing Specialist Starting Pay Rate : $18.00 / hour. Earn more based on Experience!

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 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!
Pharmacy Billing Specialist Position Overview:

The Pharmacy Billing Specialist is responsible for electronic billing of Medicare, Medicaid and Third Party Insurance claims, utilizing Frameworks LTC Pharmacy system. This position also is responsible for Skilled Nursing Facility, Assisted Living Facility and Private pay billing.

Shift: Days - 8a.m.- 4 p.m. or 9a.m.-5p.m.

#Talroo
Responsibilities:
Pharmacy Billing Specialist Responsibilities:
  • Electronic billing of Medicare, Medicaid and Third Party Insurance claims utilizing Framework LTC Pharmacy system.
  • Skilled Nursing Facility, Assisted Living Facility and Private pay claim billing
  • Troubleshoot rejected insurance claims resulting in payments
  • Prior Authorizations required from Third Party Insurance
  • Bill/Invoice Review
  • Medicaid Pending Status Review
  • Updated Skilled Nursing Facility Census and Resident Payer Status
  • Process Private Pay refunds
  • Collections on accounts
  • Daily cash deposit and posting
  • Third Party (835) downloading of remits into system
  • Process Credits/Returns
  • Projects as needed
  • Customer Service orientated (external and internal)
Base wages increase with experience!
Qualifications:
Pharmacy Billing Specialist Qualifications:
  • 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 (ACCPAC), NET Rx and Framework LTC software experience preferred
  • Microsoft Office proficiency (Excel, Work and Outlook)
  • 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 Statement: WE 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.

Salary : $18

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