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Role Description

The Pharmacy Billing Specialist is responsible for collecting, posting, and managing patient account payments. The position is responsible for submitting patient claims to insurance companies and following up on claims with insurance companies.

Supervisory Responsibilities:

• This position has no direct supervisory responsibilities.

Essential Duties and Responsibilities:

• Preparing and submitting clean claims to various insurance companies either electronically or by paper.
• Answering questions from patients, clerical staff, and insurance companies.
• Identifying and resolving patient billing complaints.
• Preparing, reviewing, and sending patient statements.
• Evaluating patient’s financial status and establishing budget payment plans; following and reporting the status of delinquent accounts.
• Reviewing accounts for possible assignments and making recommendations to the Billing Supervisor.
• Preparing information for the collection agency.
• Performing various collection actions including contacting patients by phone; correcting and resubmitting claims to third-party payers.
• Participating in educational activities and attending monthly staff meetings.
• Maintaining the strictest confidentiality; adhering to all HIPAA guidelines and regulations.

Qualifications

• Detail-oriented and accurate.
• Ability to operate a computer, computer software, and basic office equipment.
• Ability to operate a multi-line telephone system.
• Skilled in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand, and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, associates, and the public.
• Proficiency in reading, writing, and speaking English is required.

Requirements

• 1 year of medical billing and collections practice experience preferred.
• Knowledge of basic medical coding and third-party operating procedures and practices preferred.
• Knowledge of business office procedures.

Certificates/Licenses/Registration

• Pharmacy Technician Certification (PTCB or NHA) required.
• Indiana and Pennsylvania State Pharmacy Technician license required.

Physical Requirements

• Work is performed indoors with potential for exposure to safety and health hazards related to a home office environment.
• Could periodically travel to other office and operational sites.
• Prolonged periods of sitting at a desk and working on a computer.

Benefits

• Competitive Medical, Dental, and Vision Insurance.
• HSA/FSA.
• Voluntary Hospital Indemnity, Critical Illness, Accident Insurance, and Short Term Disability.
• Voluntary Life Insurance for Self, Spouse, and Dependent.
• Company-paid Basic Life Insurance and Long Term Disability.
• Retirement plan and Employer match contribution with Profit Share.
• Tuition Reimbursement program.
• Company perks and Discount program.
• Engaging Wellness and Financial Education Resources.
• Employee Assistance Program.
• Incentive Plans.

Base Hourly Minimum

$18.00

Base Hourly Maximum

$21.00