Job Details

Pharmacy Billing Specialist

  2025-11-19     CommuniCare Corporate     Cabin Creek,WV  
Description:

Pharmacy Billing Specialist

Job Address: 15063 MacCorkle Avenue Cabin Creek, WV 25035

Job Description: Pharmacy Billing Specialist

Reports to: Pharmacy Billing Supervisor

Job Type: Full-Time Hybrid/Remote Pharmacies: West Virginia, Ohio, Indiana and Maryland

Position Overview: Manage and update patient accounts to ensure consistent billing processes for all payers as outlined in the billing manual.

Key Responsibilities:

  • Follow all billing processes as outlined in the billing manual to ensure consistency and prescription integrity for compliance
  • Maintain all current patient accounts by verifying, adding or editing current insurance (Medicare Part D, Commercial, Medicaid, Medicare A and Managed Care)
  • Works closely with the facility business office managers for Medicare Part D insurance plans and Census clarifications
  • Works directly with several hospice plans and third party plans as needed
  • Daily reviews of SQL reports setup to ensure a clean facility invoice
  • Any other assigned duties that relates to billing
  • Follow federal and state regulations
  • Adhere to company policies and procedures
  • Follow HIPPA guidelines and regulations

Qualifications:

  • Previous Long-Term Care pharmacy experience a plus (but not required)
  • Knowledge of Framework LTC a plus (but not required)

Salary and Benefits:

  • Competitive salary commensurate with experience
  • Comprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more


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