Top 71 medicare part d pbm Jobs

Infusion Pharmacy Collections/Billing Specialist
Apex Infusion Pharmacy —Signal Hill, CA
- $25 - $35 an hour
- Overtime
- Research
- Mid-level
- Office
- Health insurance
- Paid time off
Quick Apply
Payor Contract Manager, Infusion
Elevance Health —Plano, TX
- Hybrid work
- 5 years
- Office
- Finance
- Employee stock purchase plan
- Paid holidays
Pharmacy Part D Auditor
Clever Care Health Plan —Huntington Beach, CA
- $80,000 - $90,000 a year
- Full-time
- Hybrid work
- Background check
- Bachelor of Science
- Mid-level
- Health insurance
Director, Channel & Pricing Strategy
Novartis —Remote
- $194,600 - $361,400 a year
- Full-time
- Remote
- Analysis skills
- Bachelor's degree
- Travel
- Health insurance
- 401(k) matching
Senior Credentialing Specialist
Onco360 —Louisville, KY
- From $26 an hour
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Paid holidays
- Disability insurance
Quick Apply
5d
Associate Director, Payer Value and Outcomes
Jazz Pharmaceuticals —Miami, FL
- $172,000 - $258,000 a year
- Medicine
- Up to 50% travel
- 5 years
- Health insurance
- Dental insurance
22h
Associate Director, Payer Value and Outcomes
Jazz Pharmaceuticals —Tampa, FL
- $172,000 - $258,000 a year
- Medicine
- Up to 50% travel
- 5 years
- Health insurance
- Dental insurance
22h
Pharmacy Program Specialist II
Harris Health —Houston, TX
- $23.46 - $29.33 an hour
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health insurance
- Dental insurance
National Account Director
TSP (A Syneos Health Company) —Boston, MA
- $240,000 - $265,000 a year
- Remote
- Up to 50% travel
- 5 years
- Master's degree
Pharmacy Technician
Imperial Management Administrators Services Inc —Pasadena, CA
- $28 - $31 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- HIPAA
Quick Apply
Senior/Commercial Pricing and Contracting Manager, Market Access
United Therapeutics —Research Triangle Park, NC
- $121,000 - $190,000 a year
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- 6 years
- Paid parental leave
- Employee stock purchase plan
Pharmacy Reimbursement Analyst
UC San Diego Health —San Diego, CA
- $37.93 - $68.68 an hour
- 8 hour shift
- Word processing
- Pass drug screening
- HIPAA
Clinical Advisor
Rxadvance Corporation —Southborough, MA
- $100,000 - $110,000 a year
- Bachelor's degree
- 1 year
- Senior level
Quick Apply
Pharmacy Technician
AlohaCare —Honolulu, HI
- $20 - $26 an hour
- Online Application
- Hybrid work
- Children
- Organizational skills
- 2 years
- Health insurance
- Dental insurance
Quick Apply
Account Executive, PBA Services
Judi Health —Houston, TX
- $160,000 - $170,000 a year
- Remote
- Bachelor of Science
- Analysis skills
- Continuous improvement
- Health insurance
Quick Apply
Senior Director, Service Delivery - Account Management - Remote
Optum —Eden Prairie, MN
- $134,600 - $230,800 a year
- Full-time
- Remote
- High school
- Pass drug screening
- Presentation skills
Quick Apply
Fraud, Waste, and Abuse Investigations Manager
MedImpact Healthcare Systems —San Diego, CA
- $85,356 - $145,107 a year
- Weekends as needed
- Microsoft Access
- Microsoft Outlook
- Computer literacy
- Paid holidays
- Disability insurance
Manager, Pharmacy Operations
SCAN Health Plan —Long Beach, CA
- $80,300 - $116,197 a year
- Full-time
- Hybrid work
- Background check
- Microsoft Access
- Microsoft Outlook
- Wellness program
- Paid holidays
Quick Apply
Sr. Account Manager PBM Service Delivery - Remote
Optum —Eden Prairie, MN
- $91,700 - $163,700 a year
- Full-time
- Remote
- Microsoft Outlook
- Pass drug screening
- Organizational skills
- Health insurance
Quick Apply
Mgr, Formulary & Pharmacy Benefits
Summa Health —Akron, OH
- $66.27 - $99.40 an hour
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Microsoft Outlook
- AD&D insurance
- Disability insurance
Quick Apply

I want to receive the latest job alert for medicare part d pbm

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

medicare part d pbm jobs near

Infusion Pharmacy Collections/Billing Specialist

Apex Infusion Pharmacy
Signal Hill, CA

Quick Apply

Job Details

Full-time
$25 - $35 an hour

Benefits

Health insurance
Paid time off
401(k) matching

Qualifications

Revenue cycle management
Accounts receivable
Medicare
Managed care
Accounts receivable management
Medical software
IV infusion
High school diploma or GED
Medical billing
Organizational skills
Medical terminology
Collections account management

Full Job Description

POSITION DESCRIPTION

* Infusion Pharmacy Billing and Collections Experience Required* *Knowledge of CPR+ software System a MUST* Electronic Adjudication PBM

Apex Infusion is looking for experienced and motivated Accounts Receivable Billing and collection specialist to join our dynamic team!

The Billing and collection Specialist is responsible for a broad range of billing processes related to managing the Ready to Bill unbilled revenue. The Billing Specialist will proactively work with assigned payer billing to maximize accurate and timely payment. Responsible for contract analysis, reimbursement, denial management, appeals and resolving billing-related issues with insurance companies or other responsible party for services rendered. Commercial, Medi-Cal, Medicare, Infusion billing experience preferred.

Major Responsibilities:

Electronic adjudication of prescription benefit claims including Part D.

· Manages the Ready to Bill queue daily; performs QA to insure accurate and timely creation of new claims and generic invoices; insures submitted claims meet payer guidelines.

· Ensures daily accomplishments work towards company goals for cash collections and A/R over 90 days, Ready to Bill under 14 days, weekly and month-end close processes, and other departmental goals as outlined.

· Strong skills and knowledge in collections and timely follow ups with insurance companies for positive outcome is highly recommended.

· Processes confirmed tickets in “unworked” status within 48 hours of confirmation date; assigns an appropriate status to ensure proper handling by branch and billing personnel; makes necessary demographic changes to reduce rejections of submitted electronic and paper claims.

· Works “resolved” unbilled tickets within 24 hours to “ready” or next status for resolution.

· Conducts billing utilizing the most efficient resources to secure timely payment of open claims or invoices; electronic solutions should be given priority.

· Identifies patterns of non-compliance by branch staff in completing patient registration, supporting billing documentation, and delivery tickets.

· Reviews delivery tickets for accuracy and completes claims per payer-specific guidelines.

· If applicable, submit secondary billing in a timely manner with appropriate supporting documentation per payer-specific guidelines to ensure expected revenue is allowed.

· Research websites of assigned payers to bill for payer updates and share updates accordingly.

· Works within specified deadlines and stressful situations.

· Works overtime when necessary to meet department goals and objectives.

· Performs other tasks or special projects as assigned.

Education/Experience:

· High School Diploma or equivalent (GED) required.

· Excellent interpersonal, communication and organizational skills required.

· Ability to prioritize, problem solve, and multitask is required.

· Knowledge of CPR + software system a MUST. A minimum of 1–2 years’ experience in Infusion Pharmacy billing and collections, with a working knowledge of managed care, commercial insurance, and Medicare reimbursement preferred. Knowledge of CPR + software system a MUST

Job Type: Full-time

Pay: $25.00 - $35.00 per hour

Expected hours: 40 per week

Benefits:

401(k) matching
Health insurance
Paid time off

Experience:

Infusion Pharmacy and CPR + Software: 2 years (Required)

Work Location: In person

Quick Apply

Refine Your Search

medicare part d pbm jobs

Infusion Pharmacy Collections/Billing Specialist

Payor Contract Manager, Infusion

Pharmacy Part D Auditor

Director, Channel & Pricing Strategy

Senior Credentialing Specialist

Associate Director, Payer Value and Outcomes

Associate Director, Payer Value and Outcomes

Pharmacy Program Specialist II

National Account Director

Pharmacy Technician

Senior/Commercial Pricing and Contracting Manager, Market Access

Pharmacy Reimbursement Analyst

Clinical Advisor

Pharmacy Technician

Account Executive, PBA Services

Senior Director, Service Delivery - Account Management - Remote

Fraud, Waste, and Abuse Investigations Manager

Manager, Pharmacy Operations

Sr. Account Manager PBM Service Delivery - Remote

Mgr, Formulary & Pharmacy Benefits

I want to receive the latest job alert for medicare part d pbm

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected