Job Details

Description

At Specialty Rx, Inc., our mission is to provide exceptional service guided by our CARE culture - Commitment, Accountability, Respect, and Excellence. The highest priority of each employee is to deliver top-quality service to our customers and colleagues, whether directly or through supporting others. This job description outlines the primary responsibilities through which employees embody our CARE values and contribute to the company's mission of outstanding service.

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

Qualifications:

• H.S. diploma or equivalent
• Third party rejections required
• Experience in Long Term Care Pharmacy preferred
• Experience in New York Pharmacy billing claims preferred
• 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
• Frameworks/ECM knowledge a plus
• Must be detail oriented

Schedule:

Flexible with the hours and the ability to work nights and weekends is a must.

• 8am - 4pm
• 9am - 5pm
• 11am - 7pm
• 12pm - 8pm
• 3pm - 11pm
• 4pm - 12am

EEO Statement, SpecialtyRx, Inc. is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation and gender identity or any other status protected by federal, state, or local law.

EO/Minorities/Females/Disabled/Veterans