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Pharmacy Billing Specialist
2 months ago
SPECIALTY RX, Inc. is seeking a highly skilled Pharmacy Billing Specialist to join our team in Ridgefield Park, NJ. As a key member of our team, you will be responsible for ensuring accurate and timely processing of medical claims.
Key Responsibilities- Claims Processing: Research and establish patient eligibility coverage with insurance providers, determine and process insurance rejections, and maintain and update patient billing and insurance information in the system.
- Insurance Interactions: Interact with insurance companies on a daily basis regarding overrides, rejections, and insurance updates, as well as with client facilities staff, PDP (Medicare), CMS, NJM, and NYM when necessary.
- Billing and Reimbursement: Follow up and resolve pending billing issues, submit prior authorizations for State insurance, and process insurance rejections by the daily report.
- Communication: Interact with clients and insurance companies via phone and email to resolve billing and reimbursement issues.
- Education: High school diploma or equivalent.
- Experience: Previous experience in retail pharmacy is a must, with experience in long-term care pharmacy preferred.
- Skills: Courteous and polite phone skills, computer literacy, ability to work nights and weekends, and experience in New York pharmacy billing claims preferred.
- Personal Qualities: Ability to work independently and as a team, multitask, and work in a fast-paced environment.
SPECIALTY RX, Inc. is a full-service pharmacy committed to employing a diverse workforce. We are an equal opportunity employer and welcome applications from qualified candidates.
