Certified Medicare D Biller

Job Summary

To support the Clinical Hub, the full-time Certified Medicare D Biller will maintain communication with healthcare facilities and insurance plans, manage prior authorization requests, and research payment denials, all while working remotely within Central Time Zone hours.

Key responsibilities

• Act as a resource for facilities in obtaining necessary documentation and following up on outstanding claims
• Make outgoing calls to facilities, plans, and physician's offices to secure prior authorizations
• Coordinate with Client Billing Service Offices and pharmacy directors to resolve customer issues effectively

Required qualifications

• High School Diploma; Associate's degree preferred, Bachelor's degree a plus
• Certified Pharmacy Technician or Medical Assistant Certification desired
• Experience in third-party medical billing
• Knowledge of EMAR systems
• Understanding of insurance and Medicaid formularies and prior authorization processes