PHARMACY BILLER RECONCILIATION SPECIALIST
Overview
: We are currently looking for a detail-oriented payment poster and reconciliation specialist to join our team. The ideal candidate will have a background in pharmacy billing, and payment posting and reconciliation. You will play a crucial role in ensuring accurate payment for services rendered and maintaining financial records
What you will do
• Third party insurance claim billing associated with the dispensing medication and using the bill method required by the payer.
• Transmit or submit claims (paper/electronic) to payors for reimbursement and reconciliations.
• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
• Review payments received via check and research ability to convert to EFT
• Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. • Research and respond to payors regarding billing issues or recovery payments that are outstanding
. • Assist in responding to audits from insurance companies. • Identify possible low payments based on trends and history
• Perform other duties as assigned by Supervisor
Preferred Qualifications:
• Previous experience in Pharmacy billing, specifically in payment posting, reconciliation, or related roles
• Experience using Microsoft Office products’ specifically Excel, Outlook, and Word
• Insurance billing or collections experience.
• Customer service in a healthcare environment. • Experience working in a healthcare reimbursement system
. • Effective customer service skills and experience that shows ability to work in a team environment
. • Attention to detail. • Ability to utilize analytical skills.
• Ability to communicate with clientele in a professional manner; both verbally and written.
• Strong attention to detail and accuracy in financial data entry.
• Must be familiar with Insurance Bins and Pcn insurance Billing.
Skills and Competencies:
• Must possess the ability to communicate with people at all levels of the organization and external agencies.
• Must be very savvy with Microsoft products and capable of learning new software
• Must be able to create reports summarizing information using tables, charts, and/or graphs
• Must be open, agreeable, and professional when gathering and referring information to the appropriate member of the team.
• Must have the ability to work alone but also in a team, with fellow staff, in the business setting. Must possess good time management skills
Job Type:
Full-time Expected hours: 40 per week Schedule:
Benefits:
• Health insurance • Paid time off Work setting:
• Office Education and Experience Requirements
• High School Diploma or Graduation Equivalent Diploma (G.E.D)
• Prior experience in a pharmacy or healthcare company.
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