DME Pharmacy Billing Specialist

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🕒 3 days ago

🗽 New York – Remote

🗽 New York – Remote

⏰ Full Time

🟢 Junior

📊 Billing Specialist

🚫👨‍🎓 No degree required

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Tarrytown Expocare Pharmacy

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2007

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2020-01

Healthcare • Healthcare Insurance • Pharmaceuticals

Tarrytown Expocare is a specialized long-term care pharmacy dedicated to serving the intellectual and developmental disability (IDD) and behavioral health communities. The pharmacy partners with nurses and support professionals to provide expert pharmacy services, ongoing training, and resources aimed at enhancing medication accuracy and efficiency. Tarrytown Expocare's mission is to deliver high-quality, compassionate, and cost-effective pharmacy solutions tailored for the unique needs of individuals in group home settings and beyond.

📋 Description

• Review DME billing for accuracy, compliance, and alignment with payer guidelines. • Verify and correct HCPCS codes, quantities, chart notes, and supporting documentation. • Adjudicate claims and follow up on unpaid claims, rejections, and denials through resolution. • Use billing systems including Frameworks LTC, ECM, and Medbill to process and manage DME claims. • Communicate with pharmacists, technicians, medical professionals, insurance companies, and pharmacy teams across multiple locations. • Identify billing issues, recommend corrections, and help improve claim accuracy and workflow efficiency. • Perform other related duties as assigned.

🎯 Requirements

• Strong knowledge of DME billing, Medicare Part B, and Medicaid billing requirements. • Ability to interpret payer guidelines and apply them accurately to claim review and submission. • Excellent verbal and written communication skills. • Strong attention to detail and ability to follow up on open items until resolved. • Proficiency with Frameworks LTC and ECM; Medbill experience preferred. • Minimum of 1 year of experience in a retail or long-term care pharmacy environment; 2+ years preferred. • 1-3 years of DME billing experience required. • Experience resolving denied or unpaid DME claims strongly preferred.

🏖️ Benefits

• Competitive compensation • Comprehensive healthcare benefits • 401(k) retirement plan • Paid time off • An awesome work environment • Opportunities to advance and grow your career • And More!