Reimbursement Manager

The Reimbursement Manager will establish and set up the accounts receivable/reimbursement department for this new long-term care pharmacy company. This candidate will establish an operating philosophy of being a world-class company that is passionate about delivering quality products and services that enrich the lives of the residents within the long-term care facilities they serve.

This department will invoice/bill primarily third-party payors such as Medicare, Medicaid, hospice, managed care insurance, nursing homes, private pay and other applicable state and federal programs. Responsibilities for pharmacy claims adjudication, AWP based reimbursement, Prescription Drug Plans (Medicare Part D) and formulary tiers.

Duties will include collections, reconciliations, split bills, rebills, refunds, external audits, problem-solving and customer service. Will also train all new employees as the company grows
REQUIREMENTS
BS/BA in either Accounting, Finance or Business is preferred, along with 2-15 years of management experience in accounts receivable reimbursement in the healthcare industry. Local candidates

The ideal candidate will have experience with pharmacy claims adjudication, AWP based reimbursement, Prescription Drug Plans (Medicare Part D) and formulary tiers.