What are the responsibilities and job description for the Pharmacy Billing Representative position at Westminster Communities of Florida?
The Westminster Pharmacy is seeking to fill a full-time position, Pharmacy Billing Representative, in our Orlando location. This position is responsible for providing knowledge of Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third Party Insurances to appropriate health care professionals, advising resident and appropriate parties on PDP options available, and enrolling and applying for low income subsidy if applicable. EOE, DFWP – We honor those who serve.
Essential Job Functions:
- Responsible for resolution of Rejections, Denials, and PA’s associated with third party insurance claims, e.g. PDPs, Medicaid, etc.
- Communication liaison regarding Medicare Part D coverage and PDPs with various business partners and stakeholders.
- Educates the staff on proper PA processes. Maintain accurate resident profiles.
- Answer incoming calls.
- Advises resident and appropriate parties on PDP options available.
- Counsels customers on assisting residents on enrolling, and applying for low income subsidy if applicable.
- Prepares various reports as requested by management, customers and residents.
- Data Entry support, as needed.
- Billing responsibilities for assigned customers.
- Travel and customer meetings, as needed.
Minimum Qualifications
- High School Diploma or equivalent. Proficiency in Word and Excel.
- 1-3 years LTC Pharmacy billing experience.
- 1-3 years experience with Frameworks and Docutrack.
- Ability to demonstrate strong organizational skills including the ability to prioritize and manage multiple tasks in a dynamic environment. Ability to demonstrate problem solving and critical thinking skills.
- Knowledge of Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third Party Insurances. Knowledge of Pharmacy’s computer software and the ability to process medication orders.
Schedule is Monday through Friday, 9:30am-6:00pm, 40 hours per week. Schedule may vary during training period.
Experience
Required- 1 - 3 years: Frameworks experience
- 1 - 3 years: LTC Billing experience
Education
Required- High School or better