Medicare D Billing Specialist

Job Summary

To support the Clinical Hub, the full-time Medicare D Billing Specialist will maintain proactive communication with pharmacists, healthcare facilities, and Prescription Drug Plans, while managing prior authorization requests and researching payment denials remotely.

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 offices to secure approvals for prior authorizations
• Ensure accurate and timely completion of prior authorization forms and maintain thorough documentation throughout the process

Required qualifications

• High School Diploma; Associates 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 and claim adjudication processes
• One to three years of pharmacy experience preferred, along with three years of call center experience