LHM LTC/PHARMACY BILLING SPECIALIST at Liberty Healthcare Management – Winston-Salem, North Carolina

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Liberty Healthcare Management

Come explore career opportunities with Liberty Health, a dynamic leader in the healthcare industry. Join us!

We are currently seeking an experienced:

PHARMACY BILLING SPECIALIST — LONG TERM CARE

Job Summary:

• Answer all incoming calls as related to assigned pharmacy accounts
• Process claims for all discharged residents on a daily basis
• Be familiar with how insurance companies pay pharmacy claims
• Contact insurance companies related to denials, rejections and prior approvals on prescriptions/orders from SNF facilities.
• Work with physicians, Nurse Practitioners and insurance plans to obtain order changes to meet formularies in order to obtain payment for orders.
• Able to maintain high volume of split billing on a daily basis.
• Obtain prior approvals for all services that require prior authorization by payer.
• Maintain follow-up file for prior authorizations and complete follow-ups.
• Enter all billing information into computer system.
• Back up billing for pharmacy done daily.
• Med Dispense billing for pharmacy done weekly.
• Must be able to work with facilities on education piece and continuing education as to the process and procedure for split billing.
• Must have good communication skills to notify facilities when not getting split billing per procedure to maintain the flow of discharge information coming to billing office.
• Obtain information for processing vaccination claims
• Any other duties as assigned.

Job Requirements:

• High School Graduate or equivalent level of education
• Certified Pharmacy Technician preferred
• Billing Experience Preferred
• Must be familiar with Part D Pharmacy Insurance Plans.
• Must be able to maintain information in a confidential manner
• Must have basic accounting abilities and ability to work with large numbers.
• Must be able to follow outlined procedures as related to billing assigned payers and expectations set forth by Manager.

Visit www.libertycareers.com for more information.
Background checks/drug-free workplace.
EOE.