Pharmacy Billing Specialist

Posted 14 Days Ago
Be an Early Applicant
Hiring Remotely in West Virginia, USA
Remote
21-23 Hourly
Entry level
Healthtech • Telehealth
The Role
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.
Summary Generated by Built In

Job Address:

15063 MacCorkle Avenue Cabin Creek, WV 25035

Job 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

Skills Required

  • Experience reviewing and working with SQL reports
  • Previous Long-Term Care pharmacy experience
  • Knowledge of Framework LTC
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The Company
19,000 Employees
Year Founded: 1984

What We Do

CommuniCare Health Services is a family-owned national leader in post-acute care, providing person-centered services for individuals with chronic or complex conditions. The company operates a diverse portfolio including skilled nursing rehabilitation facilities, long-term care centers, assisted living communities, and long-term acute care hospitals. Founded in 1984, CommuniCare is dedicated to improving the lives of its residents through high-quality, coordinated clinical care.

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