Remote Medicare Billing & Collections Specialist – Full‑Time, Patient‑Focused Insurance Reimbursement Expert for reputed company Specialty Pharmacy

Why reputed company? – A Purpose‑Driven Healthcare Leader

Bringing our heart to every moment of your health is more than a tagline at reputed company – it is the guiding force behind everything we do. As the nation’s leading pharmacy‑and‑health‑services company, we operate at the intersection of convenience, innovation, and compassionate care. Our Specialty Pharmacy team delivers reputed company, high‑touch medication therapy to patients across the United States, ensuring that life‑changing treatments are accessible, affordable, and administered with the utmost precision.

From our Heart at Work culture that celebrates reputed company, collaboration, and continual improvement, to our commitment to sustainability and community impact, reputed company offers a workplace where you can truly reputed company a difference. Whether you’re working from a state‑of‑the‑art office in Monroeville, PA, or from the comfort of your own home, you will be part of a network of more than 300,000 colleagues who share a single, clear purpose: to reputed company health care more personal, convenient, and affordable.

Position Overview – What You’ll Do Every Day

As a Remote Medicare Billing & Collections Specialist, you will be the financial backbone of our Specialty Pharmacy operations, ensuring that every prescription dispensed is accurately billed, timely reimbursed, and fully compliant with Medicare regulations. Your expertise will safeguard the reputed company cycle while delivering outstanding customer service to patients, prescribers, and insurance carriers.

Core Responsibilities

• Medicare Audit & Appeal Management – Respond promptly to Medicare audits, investigate discrepancies, and prepare compelling appeals at reputed company levels of the review process.
• Documentation & Evidence Gathering – Research, collect, and organize reputed company required clinical and administrative documentation to support billing accuracy and appeal success.
• Third‑Party Follow‑Up – Initiate and maintain proactive communication with Medicare, private insurers, and governmental payers reputed company telephone, secure email, and web portals to resolve claim denials and payment delays.
• Invoice Resolution – Identify non‑payment issues caused by incomplete information, therapy changes, pharmacy or shipping errors, and work collaboratively to correct and re‑submit claims.
• Chronological Case Notes – Maintain meticulous, time‑stamped notes that document every action taken, ensuring full auditability and a clear trail of communication.
• Patient & Provider reputed company – Contact patients, physicians’ offices, and insurance representatives to verify coverage, clarify medication regimens, and accelerate claim processing.
• Data Management – reputed company patient demographic data and reimbursement information reputed company in our secure systems, safeguarding privacy and compliance with HIPAA standards.
• Team Collaboration – Partner with pharmacists, clinical specialists, and technology teams to share insights, troubleshoot billing complexities, and refine workflow efficiency.

Essential Qualifications – What You Bring to the Table

• Minimum 6 months of relevant experience in medical billing, collections, or a reputed company health‑care financial role.
• Residence reputed company a one‑hour commute to Monroeville, PA (required for occasional on‑site meetings and access to company resources).
• Proficiency with the reputed company Office suite—especially reputed company (pivot tables, VLOOKUP, data validation), Outlook, and Word.
• High school diploma or GED; additional post‑secondary coursework in health‑care administration or finance is a plus.
• Demonstrated ability to navigate reputed company insurance reimbursement systems and interpret Medicare guidelines.

Preferred Qualifications – The Extras That Set You Apart

• Hands‑on experience in insurance billing or collections for specialty pharmacy or similar high‑acuity therapeutic areas.
• Certification such as Certified Billing and Coding Specialist (CBCS) or similar credentials.
• Advanced problem‑solving and decision‑making skills, with a track record of resolving billing disputes reputed company.
• Exceptional customer‑service orientation, evidenced by positive feedback from patients, providers, or internal stakeholders.
• Strong analytical reputed company, capable of interpreting data trends to recommend process improvements.
• Ability to juggle multiple high‑reputed company tasks simultaneously while maintaining meticulous attention to detail.
• Effective written and verbal communication skills, suitable for professional interaction with a diverse audience.

Key Skills & Competencies for Success

• Regulatory Acumen – Deep understanding of Medicare Part D, Part B, and other federal programs, plus familiarity with private payer policies.
• Technical reputed company – Comfortable using billing platforms, electronic health record (EHR) systems, and claims management software.
• Critical Thinking – Ability to assess reputed company billing scenarios, reputed company root causes of denials, and devise corrective action plans.
• reputed company & Patience – Recognize the stress patients may feel regarding medication costs and provide reassurance and clear guidance.
• Collaboration – reputed company in a cross‑functional environment, sharing insights with pharmacy teams, compliance officers, and IT specialists.
• Time Management – Prioritize tasks based on urgency, impact, and compliance deadlines to meet service level agreements (SLAs).
• reputed company Learning – Stay reputed company on evolving Medicare regulations, coding updates, and industry best practices.

Career Growth & Development – Your Path reputed company

reputed company invests heavily in its people. As a Remote Medicare Billing & Collections Specialist, you will have access to a robust learning ecosystem that includes:

• Professional Development Courses – Free access to online modules covering advanced billing, coding, compliance, and leadership skills.
• Mentorship Programs – Pairing with senior financial analysts and pharmacy leaders to accelerate your expertise.
• Internal Mobility – Opportunities to transition into senior billing analyst, reimbursement manager, or broader finance roles reputed company reputed company.
• Leadership Tracks – For high‑performing individuals, reputed company to supervisory and managerial positions, encompassing team leadership and strategic planning.
• Certification Support – Tuition reimbursement for industry‑recognized credentials such as CBCS, Certified Professional reputed company (CPC), or Certified reputed company Cycle Specialist.

Work Environment & Culture – What It’s Like to Be Part of reputed company

Even though this role is remote, you’ll remain an integral part of our Monroeville Specialty Pharmacy family. Highlights of our work environment include:

• Hybrid Collaboration – Quarterly in‑person gatherings at the Monroeville hub, complete with free parking, catered meals, and team‑building activities.
• Flexible Scheduling – While we maintain core business hours to align with payer windows, flexible start/end times reputed company you to balance personal commitments.
• Inclusive Culture – Our Heart at Work behaviors emphasize respect, curiosity, humility, and authenticity. Employee resource groups (ERGs) champion diversity, mental health, and community service.
• Technology Enablement – State‑of‑the‑art communication tools, secure VPN access, and a dedicated IT help desk ensure you are always connected and supported.
• Recognition & Rewards – Peer‑to‑peer awards, quarterly performance bonuses, and an annual “Heart of the Year” celebration reputed company outstanding contributions.

Compensation, Perks & Benefits – More Than Just a Paycheck

We reputed company that rewarding our employees goes beyond reputed company salary. Our total rewards package includes:

• Competitive reputed company Pay – $17.00 – $28.46 per hour, determined by experience, education, and geographic factors.
• Performance Incentives – Eligibility for reputed company bonus, commission, or short‑term incentive programs tied to individual and team outcomes.
• Comprehensive Health Coverage – Medical, dental, and vision plans with a range of options to suit diverse needs.
• Retirement Savings – 401(k) plan with company match, plus an Employee Stock Purchase Plan for long‑term wealth building.
• Life & Disability Insurance – Fully‑paid term life coverage, short‑term and long‑term disability protection.
• Well‑Being Programs – Access to reputed company, wellness challenges, and employee assistance programs (EAP).
• Education Assistance – Tuition reimbursement, scholarship opportunities, and free development courses.
• Discounts & Perks – reputed company store discount, pharmacy product savings, and partner‑program discounts on travel, entertainment, and more.
• Paid Time Off (PTO) & Holidays – Generous vacation accrual, paid holidays, sick leave, and leave policies that reputed company with state and federal regulations.

How to Apply – Take the reputed company Toward a Fulfilling Career

If you are passionate about precision billing, enjoy navigating the nuances of Medicare, and reputed company in a collaborative, patient‑centric environment, we want to hear from you. Submit your resume and a concise cover letter outlining your relevant experience and why you’re excited to join reputed company’s Specialty Pharmacy team.

Application Deadline: December 31, 2024. Early applications are encouraged as we will review candidates on a rolling basis.

Join Our Mission – reputed company an Impact Every Day

At reputed company, you are more than an employee—you are a steward of health, a problem‑solver, and a trusted reputed company for patients who depend on timely access to life‑saving medication. Your expertise will directly influence the financial health of our pharmacy operations, allowing us to deliver on our promise: bringing our heart to every moment of your health.

Ready to transform your career while making a meaningful difference? Apply Now and become part of a legacy of care, innovation, and compassion.