Billing Representative- Remote

Summary

SpecialtyRx, Inc. is a pharmacy services company committed to exceptional service through its CARE culture. The Billing Representative researches patient insurance eligibility, processes billing rejections, maintains billing information, submits prior authorizations, and follows up on pending billing issues.

Responsibilities

• Perform duties assigned by the Billing Supervisor
• Research and establish patient eligibility coverage with insurance providers (state and private)
• Determine and process insurance rejections in accordance with the daily report
• Maintain and update patient billing and insurance information in the system
• Submit prior authorizations for State insurance
• Interact with insurance company on daily basis, i.e., overrides, rejections, and insurance updates
• Interact with client facilities staff, PDP (Medicare), CMS, NJM and NYM, if necessary
• Follow up and resolved pending billing issues

Skills

• H.S. diploma or equivalent
• Third party rejections *required*
• Courteous and polite phone skills
• Computer literate
• Previous experience in pharmacy
• Must be able to work independently and as a team
• Ability to multitask and work in a fast-paced environment a must
• Must be detail oriented
• Flexible with the hours and the ability to work nights and weekends is a must
• Experience in Long Term Care Pharmacy *preferred*
• Experience in New York Pharmacy billing claims *preferred*
• Frameworks/ECM knowledge a plus

Qualifications

Must Haves

• H.S. diploma or equivalent
• Third party rejections *required*
• Courteous and polite phone skills
• Computer literate
• Previous experience in pharmacy
• Must be able to work independently and as a team
• Ability to multitask and work in a fast-paced environment a must
• Must be detail oriented
• Flexible with the hours and the ability to work nights and weekends is a must

Nice to Haves

• Experience in Long Term Care Pharmacy *preferred*
• Experience in New York Pharmacy billing claims *preferred*
• Frameworks/ECM knowledge a plus

Benefits

• Remote work arrangement
• Flexible hours