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Supervisor Medical Claims Support

3 months ago

Louisville, Kentucky, United States ConnectMed360 Full time
ConnectMed360 is seeking Program Support Supervisor role. This position can be fully remote. We offer quarterly incentive bonuses with plenty of growth opportunities
It's an opportunity to connect and care for our patients, providers, communities and each other.

We succeed when you do, and our company and management team work hard to foster an environment that provides you with opportunities for both professional and personal growth.

ConnectMed360 is a unique model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.

Medical; Dental; Paid Time Off and Paid Holidays
Tuition Reimbursement
and short and long-term disability

The Program Support Supervisor is responsible for supervising the accuracy and timeliness of the program's billing function, prescription fulfillment process, and pharmacy/medical benefits investigations.

Helps with the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims adjustments.

Ensures that all prescriptions are billed in accordance with Medicare/DMEPOS regulations and that all required information is documented on the hardcopy prescription.

Communicates as required with client/patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about billing.

Oversees record keeping so that all information is accurate and complete and manages the flow of up-to-date information between billing department and other parts of the Company, such as the accounts receivable, accounts payable and customer service departments.

Assists with developing, reviewing, and suggesting changes to prescription fulfillment department policies and procedures as needed.
Helps with the completion of pharmacy and medical cases when needed.
Assists with managing and training staff in benefits investigations.
Monitors daily calls/cases/chats.
Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards

Work Experience:

Required:

Ability to organize and plan the activities of team, delegate appropriately, provide superior level of customer service, and computer experience to include accounting and billing software.

Registration/Certification with Board of Pharmacy as required by law