Pharmacy Billing Specialist

We are seeking a detail-oriented and experienced Pharmacy Billing Specialist to join our team. This role is essential in supporting our long-term care pharmacy operations, ensuring accurate billing processes, and maintaining positive relationships with our partner facilities.

Billing & Pre-Billing

• Process daily census and payor changes
• Apply credits and invoices to customer accounts
• Review and correct un-billed charge reports before month-end
• Prepare and send accurate facility and private pay statements
• Respond to audit requests and facility billing inquiries
• Provide price quotes and electronic billing as requested
• Collaborate in streamlining billing processes and updating policies

Collections & Customer Relations

• Maintain accounts receivable for assigned facilities
• Investigate and resolve non-payment issues
• Maintain organized records and strong relationships with facility Business Office Managers

General Office Duties

• Attend training to improve work performance
• Perform other duties as assigned by management

Qualifications

• Previous experience in long-term care pharmacy or pharmacy team management preferred
• Knowledge of Medicare, Medicaid, hospice, and insurance billing types required
• Familiarity with medical terminology and brand/generic medications essential
• Demonstrated understanding of long-term care pharmacy workflow

Skills and Competencies

• Proficient in Microsoft Excel or similar applications
• Experience with FrameworkLTC, FrameworkECM, and Sage300 (preferred)
• In-depth knowledge of pharmacy insurance claims adjudication
• Strong communication, time management, and multitasking abilities
• Capable of working efficiently in a fast-paced team environment