We are seeking a skilled Pharmacy Biller to join our team in ensuring the accurate and timely billing of pharmacy services. This role will focus on maintaining precise and up-to-date records, resolving billing discrepancies, ensuring accurate claim adjudication, and meeting all billing regulations.
Job Description
This position will involve handling interactions with third-party payers, including Pharmacy Benefit Managers (PBMs), as well as managing patient communications regarding insurance issues. You will also ensure a high level of customer service and contribute to improving processes within the pharmacy benefit management framework.
Duties and Responsibilities
* Update and rebill National Drug Codes (NDCs) and ensure accurate billing for pharmacy claims.
* Perform electronic billing adjudication for claims and address claim rejections.
* Contact insurance companies to resolve billing issues, including claim rejections and overrides.
* Manage prior authorization requests.
* Work closely with both patients and payers to ensure the accurate adjudication of claims.
* Collect copayments and ensure that all billing records are up-to-date.
* Communicate with patients regarding insurance issues and ensure timely follow-up.
Requirements
To be successful in this role, you will need:
* A minimum of 1 year of experience in retail or independent pharmacy.
* A minimum of 2 years of experience in pharmacy billing and/or collections, with 2-3 years of experience in PBM billing.
* A strong ability to perform tasks accurately and efficiently.
* A strong communication skill, both oral and written, with the ability to convey complex insurance issues clearly to patients and third parties.
* A strong ability to prioritize tasks and manage multiple projects simultaneously.
* The ability to work independently, meet deadlines, and remain flexible.
Benefits
We offer a comprehensive benefits package, including:
* A full benefits package including medical, dental, vision, life that fits your lifestyle and goals.
* Great pay and general compensation structures.
* An employee assistance program to assist with mental health, legal questions, financial counseling, etc.
* Comprehensive PTO and sick leave options.
* A 401k program.
* Plenty of opportunities for growth and advancement.
* Company-sponsored outings and team-building events.
* Casual Fridays.
About Us
We are a rapidly growing healthcare company that values new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.
Seniority Level
This is an entry-level position.
Employment Type
Other
Job Function
Accounting/Auditing and Finance