[Hiring] Medicare B Specialist @BrightSpring Health Services

Role Description

The Medicare B Specialist will be responsible for research, billing, collections, and/or resolution of an assigned account portfolio in accordance with PharMerica’s policies. The position requires a high level of attention to detail when initiating, processing, and tracking prior authorizations on behalf of customers. Working closely with EMAR systems, healthcare facilities, and clinical teams, the Medicare D Biller serves as a key point of contact throughout the prior authorization process, ensuring efficient coordination, thorough documentation, and successful resolution of authorization requests.

Qualifications

• High School Diploma or GED; Associate degree desired
• Two years billing and/or collections experience; Medicare B preferred
• Familiarity with standard concepts, practices, and procedures with discipline
• Certified Pharmacy Technician
• Strong analytical, communication, and interpersonal skills

Requirements

• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, policies and procedures, Corporate Compliance Agreement, applicable federal and state laws, and professional standards
• Investigates Medicare B eligibility such as diagnosis, place of service, and medication for payment
• Prepares assignment of benefits, written orders, and obtains signatures from responsible parties
• Collects refill requests and dated manifest for each dispense
• Transmits electronic claim to Medicare B and after primary payment is received, prepares claim for secondary payer when applicable
• Responds to Medicare payer audits
• Maintains a thorough knowledge of Medicare coverage criteria, billing, coding, and documentation requirements

Benefits

• Medical, Dental, Vision insurance
• Health Savings & Flexible Spending Accounts (up to $5,000 for childcare)
• Tuition discounts & reimbursement
• 401(k)
• Company Paid Time Off*
• Shift Differential
• DailyPay
• Pet Insurance
• Employee wellness and discount programs