Pharmacy Billing Specialist - Long-Term Care |

Frameworks Experience Location:

Norristown, PA Job Type:

Temp-to-Permanent |

Full-Time Schedule:

Monday-Friday, 8:00 AM-4:30

PM Industry:

Long-Term Care Pharmacy Immediate Opening - Pharmacy Billing Specialist PharmPro is seeking an experienced Pharmacy Billing Specialist for our client, a Long-Term Care pharmacy in Norristown, PA . This is a temp-to-permanent, full-time opportunity for a billing professional with pharmacy experience and hands-on Frameworks pharmacy software experience . Key Requirements Frameworks pharmacy software experience is required. We are looking for candidates with experience in: Pharmacy billing Third-party insurance billing Medicare and Medicaid Prescription claims adjudication Insurance eligibility and benefit verification Long-Term Care pharmacy billing Resolving rejected pharmacy claims Prior authorizations and claim corrections Pharmacy Technician Certification (CPhT/PTCB) is preferred. Candidates must be applying for or eligible for Pennsylvania pharmacy technician registration/licensure as required by the PA State Board of Pharmacy. Responsibilities As a Pharmacy Billing Specialist, you will be responsible for accurate and timely pharmacy billing, insurance verification, claims processing, and account follow-up.

Responsibilities include:

Verify patient eligibility and insurance coverage with private and government insurance providers. Reverify benefits and coverage as needed during claims follow-up. Enter and maintain accurate patient and insurance information in the pharmacy billing system. Process and adjudicate prescription claims. Research and resolve rejected claims, eligibility issues, prior authorizations, and other billing problems. Correct claims and rebill as necessary. Maintain and audit patient files and supporting documentation to ensure compliance and prepare for third-party audits. Respond to billing questions from patients, responsible parties, facilities, and other customers by phone and electronic communication. Research and resolve billing issues involving insurance eligibility, coverage, and benefits. Assist residents and responsible parties with Medicare plan comparisons during open and special enrollment periods. Review patient profiles, medication regimens, and insurance coverage to identify potential cost-saving opportunities. Develop and maintain knowledge of Long-Term Care pharmacy billing requirements, including Medicare, Medicaid, Prescription Drug Plans (PDPs), and third-party insurance. Maintain accurate documentation and follow company and payer billing requirements. Qualifications High school diploma or GED required. Pharmacy billing experience required. Frameworks pharmacy software experience required. Long-Term Care pharmacy billing experience strongly preferred. CPhT/PTCB certification preferred. Must be applying for or eligible for Pennsylvania pharmacy technician registration/licensure according to state requirements. Strong knowledge of pharmacy insurance billing and claims processing. Strong computer and data-entry skills. Excellent attention to detail and accuracy. Strong problem-solving and communication skills. Ability to work independently and manage multiple billing tasks in a fast-paced pharmacy environment. Schedule & Opportunity Monday-Friday | 8:00 AM-4:30 PM Temp-to-Permanent | Full-Time If you have pharmacy billing experience and Frameworks experience , this could be an excellent opportunity to join a Long-Term Care pharmacy team in the Norristown area. Apply today! Qualified candidates with Frameworks pharmacy software experience are encouraged to submit their resume for immediate consideration.

Pay:

$22.00 - $23.00 per hour Application Question(s): Do you have Framework's experience? If offer the position, when can you start? Are you a PA. registered pharmacy Technician? Do you have Pharmacy Billing (Dealbreaker)

Work Location:

In person