Billing Specialist I will be responsible for qualifying, preparing and submitting claims to Medicare Part B, Major Medical and Medicaid. Individuals must work with LTC facility staff, Omnicare pharmacy operations staff, prescriber offices, third party payers, patients and/or their responsible parties and claim processors. This position requires work within several different operating systems and web based programs to retrieve document images, collect supporting or additional information on fills and work claims through to resolution to ensure compliant, timely and accurate billing practices.
Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full-time billing/collections representative. The Pharmacy Billing/Collections Representative will ensure timely and accurate billing for unbilled claims and ensure account payment for outstanding balances while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers.
Key Responsibilities of the Pharmacy Billing Representative:
- Third Party insurance claim billing and follow up associated with the dispensing of prescription medication using the bill method required by the payer.
- Transmit or submit claims (paper, electronic) to insurance payers for reimbursement.
- Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
- Maintain supporting chronological notes that detail actions taken to resolve outstanding unbilled claims.
- Maintain patient demographic information in data collections systems.
- Work all billing reports and queues while remaining in accordance with payer and company policy guidelines.
- Research and respond by telephone, via the internet and in writing to patients, physician's offices, insurance companies and governmental payers regarding billing issues and problems as well to expedite claims processing.
Job Duration: 03/27/2023 to 03/09/2024
Schedule: Mon- Friday 8:00 AM - 4:30 PM EDT
