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Billing Operations Specialist
2 weeks ago
Responsibilities:
- Bills specialty pharmacy claims, both NCPDP format and CMS 1500 format.
- Researches Electronic 837 capabilities.
- Collections on past due assigned accounts.
- Researches and processes refunds as required.
- Denials trending.
- Prepares Bad Debt Write-Offs as required.
- Reconciles member accounts as needed.
- Handles multiple tasks and meet deadlines.
- Other duties as assigned within scope of practice.
- Bachelor’s degree in business or related field required. Equivalent work experience may substitute education requirements.
- Detailed understanding of both Medical and Pharmacy billing/collections practices with all payer types
- Excellent oral and written communication skills and able to communicate effectively with all levels of management.
- Strong problem-solving skills to evaluate all aspects of a problem or opportunity and draw valid conclusions to make appropriate and timely decisions.
- Uses tact, sensitivity, sound judgement, and a professional attitude constantly.
- Knowledge of Microsoft Office Suite, especially Excel, Outlook, and PowerPoint
- 2 years of medical billing/collections knowledge in a specialty pharmacy setting
- 837 (EDI) medical billing knowledge
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