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Our Company

PharMerica

Overview

Join our PharMerica team! PharMerica is aclosed-door pharmacywhere you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh growth mode, which meansadvancement opportunitiesfor individuals who are looking for career progression!

TheMedicare D Billing Representativeserves as a key point of contact for the Clinical Hub and proactively communicates with Pharmacists, Facilities, Physicians and PDP’s regarding Therapeutic Interchanges and prior authorization requests. Responsible for investigating and calling plans to determine the reasons for payment denials and Facilities to provide the reasons for denial, while updating and documenting prior authorizations with clinical justifications. To provide high level of attention to detail while initiating and completing the Prior Authorization forms for our customers. Working with EMAR systems, as well as, facilities and serving as key contact for the completion of Prior Authorizations.NOTE: pharmacy experience preferred

This isa hybrid position.Applicants must reside in, or a commutable distance to Arlington, TX and will work onsite 3 days per week.

Schedule:

Monday - Friday 9:30am - 6:00pm Central Time

We offer:

DailyPay

Flexible schedules

Competitive pay

Shift differential

Health, dental, vision and life insurance benefits

Company paid STD and LTD

Tuition Assistance

Employee Discount Program

401k

Paid-time off

Tuition reimbursement

Non-retail/Closed-door environment

Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!

Responsibilities

+ Act as a resource to the facilities in obtaining information completing necessary documentation or following up on outstanding claims

+ Individual with an understanding of Insurance and Medicaid formularies and processes including the prior authorization processes

+ Makes outgoing calls to Facilities, Plans, and Physician’s offices as needed to obtain approvals

+ Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to effectively communicate and resolve customer issues

+ Performs other tasks as assigned

+ Achieves productivity goals with regard to calls/claims per hour as determined by the Director and Clinical Hub Manager

+ Provide clinical support to members of the RxAllow team regarding prior authorization concerns / submissions

+ Conducts job responsibilities in accordance with the standards set out in the Company’s code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and State Laws, and applicable professional standards

+ Familiar with the claim adjudication process

+ Develop a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow

Qualifications

+ High School Diploma, Associates degree; Bachelor's degree preferred

+ Certified Pharmacy Technician or Medical Assistant Certification desired

+ Third party Medical Billing experience

+ EMAR system knowledge

+ One to three years of pharmacy experience preferred

+ Three years of call center experience preferred

+ Understanding of insurance and medicaid formularies and processes including the prior authorization processes

+ Familiar with the claim adjudication process

+ Proficiency in Microsoft Office programs

+ Prioritize work to meet daily and competing deadlines

About our Line of Business

PharMerica, an affiliate of BrightSpring Health Services, is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations, and post-acute care organizations. PharMerica is one of the nation's largest pharmacy companies, offering unmatched company culture, employee development, and advancement opportunities. For more information, please visitwww.pharmerica.com. Follow us onFacebook (https://www.facebook.com/PharMericaCorp) ,LinkedIn (https://www.linkedin.com/company/pharmerica) , andX (https://x.com/PharMericaCorp) .

ALERT: We are aware of a scam whereby imposters are posing as employees from our company. Beware of anyone requesting financial or personal information. We take pride in creating a best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, driver’s license, bank information, or payment for work equipment, etc.) from you via text or email. If you are suspicious of a job posting or job-related email mentioning our company, please contact us at [email protected] .

Click here (https://www.brightspringhealth.com/careers/frequently-asked-questions/) for additional FAQ information.

Job LocationsUS-TX-ARLINGTON

ID 2025-170856

Line of Business PharMerica

Position Type Full-Time