Medicare D Billing Specialist

Job Summary

Serving as a primary liaison for the Clinical Hub, the full-time Medicare D Billing Specialist will manage communication with pharmacists, healthcare facilities, and insurance plans, while researching payment denials and coordinating prior authorization requests in a remote setting.

Key responsibilities

• Act as a resource for facilities in completing necessary documentation and following up on outstanding claims
• Make outgoing calls to obtain approvals from facilities, plans, and physician's offices as needed
• Update and document prior authorizations, ensuring accurate and timely completion of all required forms

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, including prior authorization processes