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Medicare Billing Representative Jobs (NOW HIRING)

BrightSpring

Medicare D Billing Representative

Louisville, KY · Remote

$15.75 - $20.25/hr

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 ...

SperoMD

Billing Representative

Northbrook, IL · On-site

$18 - $23.75/hr

Medical Billing Representative - Hybrid schedule, must be able to commute to Northbrook, Illinois ... Familiarity with Medicare, Medicaid, and commercial insurance billing and plans * Ability to work ...

Speromd LLC

Billing Representative

Northbrook, IL · On-site

$18 - $25/hr

Medical Billing Representative - Hybrid schedule, must be able to commute to Northbrook, Illinois ... Familiarity with Medicare, Medicaid, and commercial insurance billing and plans * Ability to work ...

Trans-Care Ambulance

Billing Representative

Terre Haute, IN · On-site

$17 - $22/hr

Review and process paper insurance denials received from commercial, Medicare, Medicaid and Managed ... Previous medical billing, patient accounts, insurance follow-up, claims processing or revenue cycle ...

340B Health

Billing Rep Rev Cycle

Temple, TX

$16.50 - $21.50/hr

Job Summary The Billing Representative submits hospital or professional claims to Payers ... This includes Medicare, Medicaid, Managed Medicare, Managed Medicaid, Managed Care, Commercial ...

Ovation Healthcare

Specialist, Medicare

This role involves processing Medicare claims, managing accounts receivable, addressing patient inquiries, and working closely with Medicare representatives to resolve billing issues. Duties and ...

Baylor Scott & White Health

Billing Rep Rev Cycle

Temple, TX · On-site

$14.25 - $18.75/hr

Job Summary The Billing Representative submits hospital or professional claims to Payers ... This includes Medicare, Medicaid, Managed Medicare, Managed Medicaid, Managed Care, Commercial ...

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Medicare Billing Representative information

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How much do medicare billing representative jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for medicare billing representative in the United States is $20.27, according to ZipRecruiter salary data. Most workers in this role earn between $17.07 and $22.36 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Medicare Billing Representative?

To excel as a Medicare Billing Representative, you need a solid understanding of medical billing and coding, healthcare reimbursement policies, and a high school diploma or equivalent, with additional certification (such as Certified Professional Biller) often preferred. Familiarity with billing software, electronic health records (EHR) systems, and Medicare regulations is essential. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and resolve billing issues with patients and insurance providers. These competencies are crucial for minimizing claim denials, ensuring compliance, and optimizing reimbursement for healthcare organizations.

What are some common challenges faced by Medicare Billing Representatives and how can they be managed?

Medicare Billing Representatives often encounter challenges such as staying current with frequently changing Medicare regulations, managing denied or rejected claims, and accurately coding complex medical procedures. To manage these, it’s important to participate in ongoing training, utilize reliable billing software, and maintain clear communication with healthcare providers and insurance representatives. Building strong organizational skills and attention to detail can also help ensure compliance and reduce errors in claims processing.

What does a Medicare Billing Representative do?

A Medicare Billing Representative is responsible for handling billing processes related to Medicare insurance claims. They submit claims to Medicare, follow up on unpaid claims, ensure accurate coding, and resolve billing issues or discrepancies. Their role often involves working with healthcare providers, patients, and insurance companies to ensure that services are billed correctly and payments are received timely. Strong attention to detail and knowledge of Medicare regulations are essential in this role.

What is the difference between Medicare Billing Representative vs Medical Billing Specialist?

AspectMedicare Billing RepresentativeMedical Billing Specialist
CredentialsHigh school diploma, Medicare-specific trainingHigh school diploma, billing certifications often preferred
Work EnvironmentHealthcare facilities, insurance companies, billing officesHospitals, clinics, medical offices, billing companies
Employer & IndustryPrimarily healthcare providers and Medicare insurersVarious healthcare settings, including private practices and hospitals
Common Search & ComparisonYesYes

The main difference is that Medicare Billing Representatives focus specifically on Medicare claims and regulations, while Medical Billing Specialists handle a broader range of insurance claims across multiple payers. Both roles require knowledge of billing procedures, but Medicare Billing Representatives have specialized training related to Medicare policies and billing processes.

More about Medicare Billing Representative jobs
What job categories do people searching Medicare Billing Representative jobs look for? The top searched job categories for Medicare Billing Representative jobs are:
Medicare Billing Representative jobs near you
Infographic showing various Medicare Billing Representative job openings in the United States as of August 2026, with employment types broken down into 85% Full Time, 13% Part Time, and 2% Contract. Highlights an 72% Physical, 1% Hybrid, and 27% Remote job distribution, with an average salary of $42,166 per year, or $20.3 per hour.

Medicare D Billing Representative

BrightSpring Health Services

Louisville, KY • Remote

$15.75 - $20.25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 14 days ago

BrightSpring Health Services rating

4.8

Company rating: 4.8 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

220th of 239 rated social care providers

Job description

PharMerica


PharMerica, a part of Brightspring Health Services, is a longterm 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 

  • 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

  • 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

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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