Jobs in the United States

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Added 5 mins ago
UG
Product Manager - Remote
UnitedHealth Group
Eden Prairie, MN
- $91,700 to $163,700 USD / year
As a Product Manager on the Epic team within Optum Insight's Provider Clinical Decision Support organization, you will provide end-to-end product management, workflow optimization, and…
Added 5 mins ago
Business Manager C (VDH03480)
Virginia Department of Health
Roanoke, VA
…implements performance improvement strategies and/or problem resolution for related issues, in conjunction with program management and Human Resource…
Added 5 mins ago
ServiceNow Project Manager
BRMi
UNAVAILABLE, VA · MD · FL · DC · WV
BRMi is seeking a ServiceNow Project Manager to support a large financial services client.
Added 7 mins ago
Advanced Pharmacy Technician, Investigative Drug Services, Cancer Center
UTSW
TX
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Added 9 mins ago
Patient Services Representative, Orthopedics-Patewood, FT, Days
Prisma Health-University Medical Group
Greenville, SC
…providing service. Participates with other staff to achieve account resolution. Assists with outpatient coding and error resolution. Processes edits and Customer Service and Collection…
Added 9 mins ago
Patient Services Representative, Orthopedics-Patewood, FT, Days
Prisma Health-University Medical Group
Greenville, SC
…providing service. Participates with other staff to achieve account resolution. Assists with outpatient coding and error resolution. Processes edits and Customer Service and Collection…
Added 9 mins ago
SI
Critical Facilities Engineering Manager
Salute Inc.
Afton, TX
- $125,000 to $140,000 USD / year
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Added 10 mins ago
Supervisor Passenger Service Operations
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Richmond, VA
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Added 11 mins ago
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Suffolk
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…assigned projects, working in partnership with the Project Manager, who leads the project’s commercial and operational delivery. The successful candidate will frame decisions, establish…
Added 12 mins ago
Medicare D Billing Representative
PharMerica
Remote, United States
…efficient coordination, thorough documentation, and successful resolution of authorization…
Added 14 mins ago
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Mesa, AZ
…responsible for maintaining adequate shop productivity. The Store Manager will recruit, hire, develop, and provide inspirational leadership and direction to the service selling and back…
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Added 17 mins ago
Theater Manager
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Added 17 mins ago
RN Managed Care Coordinator I
BlueCross and BlueShield of South Carolina
Remote, United States
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Added 17 mins ago
WN
Physical Plant Building and Excavating
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- $25 to $35 USD / hour
Safety – Engage with coworkers to reduce workplace accidents. Report any safety concerns to manager immediately.
Added 20 mins ago
General Manager
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Wichita Falls, TX
The Courtyard Marriott Wichita Falls is looking for a General Manager that drives operational excellence, maximizes profitability, and delivers exceptional guest experiences. Responsible…
Added 24 mins ago
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Epic Radiant Analyst (Ex-Epic)
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- $85 to $95 USD / hour
…This role will primarily focus on day-to-day support, issue resolution, enhancement requests, and system maintenance rather than large-scale implementation work. While the position is fully…
Added 25 mins ago
Sr Manager, Customer Experience Data Strategy /Database Owner
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REYNOLDS AMERICAN has an exciting opportunity for a Sr Manager, Sr Manager, Customer Experience Data Strategy /Database Owner in Winston-Salem, NC
Added 25 mins ago
VH
Registered Nurse (Residential Rehabilitation Treatment Program)
Veterans Health Administration
Sheridan, WY
- $77,471 to $146,587 USD / year
Reports safety concerns and assists and/or directs safety concern resolution.
Added 25 mins ago
BO
SUPERVISORY CIVIL ENGINEER
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Lakewood, CO
- $140,239 to $182,316 USD / year
-Lead project decision making, issue resolution, and continuous improvement to support mission success.
Added 25 mins ago
BO
SUPERVISORY CIVIL ENGINEER
Bureau of Reclamation
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- $140,239 to $182,316 USD / year
-Lead project decision making, issue resolution, and continuous improvement to support mission success.
Added 25 mins ago
Manager, Leaves & Accommodations (Remote)
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Proactively works to mitigate risk and contain liability to the organization; escalates issues as appropriate for further resolution.
Added 26 mins ago
NM
Nurse Manager of Operations-Med Surg, Evenings and Nights
Northwestern Memorial Healthcare
Geneva, IL
- $60.5 to $78.65 USD / hour
The Nurse Manager, Operations reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant…
Added 26 mins ago
NM
Nursing Manager of Ops-Interventional Services
Northwestern Memorial Healthcare
Lake Forest, IL
- $60.5 to $78.65 USD / hour
The Manager, Operations reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant…
Added 26 mins ago
NM
Manager Operations (Nursing)
Northwestern Memorial Healthcare
Winfield, IL
- $60.5 to $78.65 USD / hour
The Manager, Operations reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant…

PharMerica

Medicare D Billing Representative

Remote, United States

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Job details

Apply by: Nov 9, 2027
Posting language: English
Posted: Nov 9, 2026

Original job description

Our Company

PharMerica

Overview

PharMerica, a part of Brightspring Health Services, is a long‑term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States.

The Medicare D Biller serves as a primary liaison for the Clinical Hub, maintaining proactive communication with pharmacists, healthcare facilities, physicians, and Prescription Drug Plans (PDPs) regarding therapeutic interchange opportunities and prior authorization requests. This role is responsible for researching payment denials by contacting insurance plans to determine the cause of denials and coordinating with facilities to obtain supporting information. Additionally, the Medicare D Biller updates and documents prior authorizations, including clinical justifications, while ensuring the accurate and timely completion of all required authorization forms.

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.

The ideal candiate will be a Certified Pharmacy Technician or Medical Assistant Certification (desired) and have Third party Medical Billing experience

Remote: May reside anywhere with the Continental USA.

No matter what time zone in which you reside, you must be able to work Central Time Zone hours

Schedule: Monday - Friday 11am - 7:30pm CENTRAL Time Zone

Benefits and perks for You!

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

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, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.

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More about this job

Skills

Attention to detail
Pharmacy technician
Medical billing
Child care
Documentation
Regulatory compliance
Workflow
Microsoft Office

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