The purpose of this position is to perform billing duties for the Pharmacy program.
This listing is not to be construed as all-inclusive. Other duties may be required and assigned.
• Prepares and processes pharmacy billing invoices, statements, and collection letters. Ensures information is being processed timely and accurately. Ensures all outstanding invoices are paid on time and contacts appropriate insurance carriers and patients to collect payment or resolve outstanding issues.
• Reviews and processes Third Party Payor and Medicaid Prior Authorization (PA) requests. Prints documentation and types the PA request to the Third Party Payor or to Medicaid. Responds to requests for additional information. Follows up on denials. Communicates with supervisor on Prior Authorization approvals and appeals.
• Reviews open accounts for collection efforts and makes decisions on closing accounts and works with supervisor to determine extending additional credit.
• Communicates with responsible payers to answer questions regarding client accounts or correcting any errors in accounts.
• Maintains and updates all month end pharmacy billing reports. Ensures reports are completed timely, accurately and meeting all standards.
• Answers incoming calls and questions in regards to pharmacy reimbursement.
Minimum Education & Experience:
High school diploma or equivalent with one to two years prior medical billing experience or any other combination of education and experience that provides equivalent knowledge, skills or abilities.
Knowledge, Skills & Abilities:
Ability to use a computer for e-mail, data inquiry, data entry, and word processing.
Ability to create and utilize basic and complex spreadsheets to record and report data.
Skilled in Outlook, Word, Excel, and billing software.
This position rates as SEDENTARY WORK as defined by the dictionary of Occupational Titles
Home Health United
- 3 years ago - save job