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About the Role
Woodmark Pharmacy of NY is seeking an experienced and detail-oriented Pharmacy Billing Specialist to join their team. This role is crucial in managing pharmacy claims and ensuring timely payments, ultimately impacting the lives of residents and their families.
Responsibilities
- Electronic billing of Medicare, Medicaid, and Third Party Insurance pharmacy claims using Framework LTC Pharmacy system.
- Billing for skilled nursing facilities, assisted living facilities, and private pay.
- Troubleshooting rejected insurance claims to ensure payment.
- Managing prior authorizations from Third Party Insurance.
- Reviewing bills and invoices.
- Reviewing Medicaid pending status.
- Rebilling Medicaid claims.
- Updating Skilled Nursing Facility Census and Resident Payer Status.
- Undertaking projects as needed.
- Providing customer service to external and internal stakeholders.
Requirements
- Associate's Degree or High School diploma (or GED).
- 1-2 years of 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.
- Sage 300 and Framework LTC software experience preferred.
- Proficiency in Microsoft Office 365.
- Excellent organizational and time management skills.
- Self-motivated with the ability to effectively solve problems.
- Ability to read, write, speak, and understand English at an intermediate or advanced level.
Skills
- Framework LTC Pharmacy system
- Medical billing
- Collections
- Pharmacy claims
- Pharmacy billing
- Sage 300
- Framework LTC software
- Microsoft Office 365
- Customer Service
- Phone Skills
- Organizational skills
- Time management skills
- Problem-solving
Location
- On-site
Work Type
- Full-time
- On-site
Experience Level
- 1-2 years experience
- Experienced
Education Level
- Associate's Degree
- High School diploma
- GED
Salary/Compensations
- Starting at $18.00 / Hour
Benefits
- Full Benefits Package - Medical, Dental, Vision, Life
- 401(k) with company match
- Competitive Pay
- Weekly Paycheck
- Solid Team Atmosphere
About the Company
- Woodmark Pharmacy of NY
Equal Opportunity
- 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.