Long-Term Care Pharmacy Biller

At Owl Western Pharmacy, we provide closed-door, sterile compounding long-term care pharmacy services for skilled nursing facilities and assisted living facilities.

We are seeking a detail-focused Long-Term Care Pharmacy Biller to manage end-to-end billing accuracy for assigned facilities. This role supports pharmacy claims, reimbursement, prior authorizations, patient account maintenance, and compliance with applicable healthcare regulations.

Key responsibilities include:

• Accurately enter and submit insurance claims for medications dispensed to long-term care facilities.
• Ensure proper coding and documentation for accurate reimbursement.
• Research and resolve claim denials and rejections from insurance companies.
• Appeal denied claims to secure reimbursement.
• Track and monitor outstanding claims and follow up on unpaid balances.
• Resolve billing errors and maintain accurate patient account records.
• Submit and manage prior authorizations for medications requiring approval.
• Enter and maintain patient demographics, insurance information, and medication data in the pharmacy management system.
• Support intake by answering incoming calls and assisting team members as needed.
• Maintain patient confidentiality and comply with HIPAA, Medicare Part D, and state regulations.