Pharmacy Billing Specialist
17 days ago
Nanuet
Job Description Company Overview We are the premier pharmacy partner for long-term-care communities that share their commitment and priority to patient-care first. We have transformed the conventional medication management process by being high-touch and patient -focused. We work tirelessly to streamline the often-disjointed communication process between the integral stakeholders in the medication ordering and administration life-cycle. How they accomplish this, is by simplifying processes, educating and communicating frequently. Our comprehensive technology solutions and breadth of pharmaceutical products and services allow us to be nimble and creative in offering the right service everyone of their unique customer needs. We understand our customers’ needs and have the industry’s highest standards with strict adherence to federal and state regulations. Position Overview We are seeking a meticulous and detail-oriented Billing Specialist experienced in pharmacy billing for residents in assisted living facilities. The ideal candidate will possess extensive knowledge of Medicare guidelines, documentation compliance, claim submission, and follow-up to ensure timely reimbursement and minimal claim denials. Location: Bardonia, NY Reports To: Billing Department Schedule: Onsite Employment Type: Full-Time Salary Range: $50,000 - $65,000 USD/Annually Key Responsibilities • Prepare and submit DME claims to Medicare Part B, ensuring accuracy and full compliance with regulatory requirements., • Verify patient eligibility and insurance coverage, with attention to assisted living facility billing requirements., • Ensure all documentation meets Medicare standards., • Track, monitor, and proactively follow up on outstanding claims, denials, and payment discrepancies., • Manage collections for patient and insurance accounts, including monitoring aging reports, identifying delinquent accounts, and prioritizing collection efforts., • Review, reconcile, and resolve billing discrepancies or disputes promptly to ensure accurate patient invoices., • Collaborate with billing and accounts receivable teams to address invoicing errors or issues impacting collections., • Maintain accurate and organized billing records and reports for internal audits., • Stay current on Medicare Part B policies and changes affecting DME billing. Qualifications • Minimum of 1-3 years of collections experience in DME and pharmacy billing, specifically with Medicare Part B., • Strong knowledge of HCPCS codes, insurance verification processes, and claims management/processing., • Experience working with assisted living facilities or similar long-term care environments required., • Proficiency with medical billing software and Electronic Health Records (EHR) systems., • Excellent attention to detail, problem-solving, and organizational skills. EEO Statement We are an Equal Opportunity Employer and we do not discriminate on the basis of race, religion, gender, national origin, age, disability, or any other status protected by applicable law. We value and are committed to creating an inclusive environment for all employees. Please Note: Topaz HR is conducting this search on behalf of one of our clients. The employer's name will be disclosed during the interview process, and all hiring decisions will be made directly by the client.