Pharmacy Collections Specialist (with previous PHARMACY experience)
Cantex Continuing Care Network - Addison, TX

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Pharmacare, a full-service, stable and growing in-house long-term care pharmacy, is seeking a full-time Pharmacy Collections Specialist for its Addison location. The qualified candidate has a strong knowledge of retail/outpatient medication billing and has energetic experience with pharmacy collections .

Monday - Friday: Daily 8-hour shifts throughout the week to make calls between hours of 8am - 8pm, including some Saturdays (plus flexibility to meet the needs of the department). You will get time off during the week to compensate for the weekend hours that you may occasionally work.

Job Summary:
This position verifies, corrects and documents responsible party information, resolves complex billing issues and follows established procedures for cash collections on private accounts. The position may require performance or supervision of clerical, receptionist or other business office related tasks.

Qualifications:

  • A high school diploma is required; a college degree or equivalent advanced courses in office management are preferred.
  • Experience in a pharmacy/medical business office environment or hospital to include 3-5 years of energetic collections experience is required.
  • Accounts receivable and medical billing knowledge/experience is preferred;
  • Computer literacy is required.
  • Proficiency in math and language usage is expected.
  • Must be able to handle potentially stressful situations and multiple tasks simultaneously.
  • Ability to read, write, and speak the English language is required.

Essential Functions:

The essential functions described below are representative of those an employee encounters while performing the basic functions of the position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. While every effort has been made to identify the essential functions of the position, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statement of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position. The Collections Specialist is at a minimum responsible for the following functions, either directly or through delegation to qualified staff:

  • Collections calls and correspondence in a fast-paced, goal-oriented collections department.
  • Ensuring that correct responsible party information is registered within pharmacy’s patient accounting systems.
  • Requesting additional information from patients, responsible parties, Pharmacy staff, and other Cantex departments to make corrections to claims.
  • Providing excellent customer service regarding collections issues, processing patient refunds, and processing/reviewing account adjustments.
  • Monitoring and maintaining assigned accounts, including collection calls, account adjustments, account reconciliations and processing credit and refund requests.
  • Reducing delinquency for assigned accounts.
  • Enlisting the efforts of the Business Office Manager and Management when necessary to accelerate the collection process.
  • Communicating timely and effectively with responsible parties, internal and external departments, Business Office, and Management regarding the status of patient accounts.
  • Processing and mailing monthly Delinquency notices.
  • Reconciling patient disputes as they pertain to payment of outstanding balances that are due.
  • Accumulating and providing data/documents for maintenance of accounts receivable ledgers.
  • Compiles data and provides cumulative reports on a daily, weekly or monthly basis as required by departmental supervisor, Business Office Manager and/or Director of Pharmacy.
  • Answers incoming calls in a timely manager.
  • Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact billing, collections and payors.
  • Adheres to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.
  • Actively participates in Business Office or Pharmacy meetings.
  • Seeks advice and guidance as necessary to ensure proper understanding.
  • Performs other duties and tasks as assigned.

Physical Demands:

  • Ability to communicate in English via phone, in writing, and verbally in conversation with different levels of staff, patients and their families, and any outside customers.
  • The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • While performing the duties of this job, the employee is frequently required to sit; use hands or fingers, handle, or feel; reach with hands and arms; talk or hear; and taste or smell.. The employee is also frequently required to stand and walk The employee must occasionally lift up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perceptions, and ability to adjust focus. Ability to utilize a computer, phone, etc. for extended periods of time.