Medicare D Billing Specialist

20 hours ago


Arlington, Virginia, United States PharMerica Full time
About PharMerica

PharMerica is a leading provider of pharmacy services to senior living communities, skilled nursing facilities, and post-acute care organizations. Our team is dedicated to delivering exceptional customer service and meeting the pharmacy needs of our clients nationwide.

Job Summary

We are seeking a highly skilled Medicare D Billing Representative to join our team. As a key member of our pharmacy group, you will be responsible for processing claims, communicating with facilities and plans, and resolving customer issues.

Responsibilities
  • Process claims and obtain necessary documentation from facilities
  • Understand insurance and Medicaid formularies and processes, including prior authorization
  • Make outgoing calls to facilities, plans, and physician's offices to obtain approvals
  • Work with client billing service offices, pharmacy directors, customers, and prescription drug plans to effectively communicate and resolve customer issues
  • Provide clinical support to members of the RxAllow team regarding prior authorization concerns
  • Achieve productivity goals with regard to calls/claims per hour
  • Prioritize work to meet daily and competing deadlines
  • Develop a strong understanding of the insurance verification, adjudication, back-end billing process, and become a subject matter expert on the insurance queues and billing workflow
Qualifications
  • Education: High School Diploma or equivalent experience
  • Desired: Associate degree/Bachelor's Degree
  • Work Experience: Third Party Medical Billing Experience
  • Desired: 1-3 years pharmacy experience; 3 years call center experience
  • Skills/Knowledge: Familiar with the claim adjudication process; Proficiency in Microsoft Office
About Our Line of Business

PharMerica is a full-service pharmacy solution providing value beyond medication. We offer unmatched employee development, exceptional company culture, and seemingly endless opportunities for advancement.

Salary Range

USD $19.50 - $21.00 / Hour



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