Pharmacy Billing Coordinator

3 weeks ago

Round Rock, United States Regency Integrated Health Services Full time

Job Details

Level: Management

Job Location: Regency IHS Pharmacy Services - Round Rock, TX

Position Type: Full Time

Education Level: High School

Salary Range: Undisclosed

Job Category: Health Care

Essential Job Functions

Primary Responsibilities

Under general direction, the Billing Coordinator ensures the supervision and directs the billing department operations, and activities of personnel; ensures the efficient and timely billing process that includes Facility Statements, Medicaid of Texas, multiple Third Party PDP's, processing and submitting Prior Authorizations to their respective party, train.

Essential Functions

* Responsible for the completion of the billing process that includes Facility Statements, Medicaid of Texas, multiple Third Party PDP's, Hospice and Medicare B billing.
* Responsible for submitting claims and following up with insurance companies.
* Prepare and submit clean claims to various insurance companies either electronically or by paper.
* Responsible for resolving and working Third Party Rejections; knowledgeable with the use of LTC overrides and submissions.
* Responsible for training and implementing the use of Cover My Meds or desired system to process Prior Authorizations.
* Reconcile third party insurance claims.
* Responsible for Scriptmax or designated claims analysis and reconciliation service weekly calls and reports.
* Responsible for working all reports provided by Scriptmax, which may include AWP retro billing and price increases, Usual and Customary pricing, Generic Utilization and DAW reporting, Contract Assure, Low-Margin report, and Submission Clarification Codes submission.
* Ensure compliance of all Short-Cycle regulations and submissions.
* Responsible for challenging all Negative Gross Profits and MAC appeals with the Third Parties.
* Responsible for EOM reports that include correct billing and reimbursement of all compounds, rebilling of claims billed to Medicare that should have been Hospice.
* Profiling and submitting claims to all our Hospice PBMs.
* Responsible for completing all contracts not handled by Innovatix; contracting, credentialing and reaccreditation with all Third Parties.
* Responsible for Medicare B accreditation, billing, submission and compliance.
* Responsible for annual Fraud, Waste and Abuse training and attestations to all Third Parties.
* Responsible for all Audits and Appeals that are requested by Third Party PDP's, Medicare A census audits, State Board, DEA and Medicaid of Texas requests for medical records and pharmacy records, Wholesaler and Drug Inventory Audits.
* Responsible for inputting all Third Party Plans into pharmacy system.
* Responsible for providing Third Party Plans with Best Available Evidence.
* Responsible for informing nursing homes of their residents needing to change Medicare-D plans due to loss of benchmarked status.
* Assist families with Medicare-D enrollment, comparisons, selections and understanding of Medicare-D plans.
* Facilitate enrollment for Low-Income Subsidy recipients via Limited-Income Net PDP.
* Responsible as the Custodian of Records for completing and providing all requests of files, documents and pharmacy records as requested for the use of legal actions by outside legal parties.
* Conduct self in accordance with SSP's employee manual.
* Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
* Provide professional customer service to all customers.

Supervisory Responsibilities

* Provide supervision of Billing Associates and assist in the hiring, wage reviews and performance evaluations of Billing Associates.
* Provide Billing Associates counseling and formal written documentation when needed.
* Participate in education activities and attend Managers meetings.
* Work closely with Innovatix and attend their Regional meetings, AR reviews, webinars and legislative calls and sessions when required.

Qualifications

Educational/Training Requirements

* High school diploma or graduate equivalent degree (GED)
* One year experience in LTC pharmacy or previous experience in related health care as Billing Manager and/or license technician
* Must be a registered certified technician or technician in training with Texas State Board of Pharmacy

  • Project Coordinator

    3 days ago

    Round Rock, United States Facility Solutions Group Inc Full time

    **Responsibilities**: - Manage document control and create a well-organized electronic filing system for all necessary documents, including, construction documents, A/E design and engineering plans and specifications, submittals, RFIs, daily report, contract/change orders, closeout documents, etc. - Assists with invoicing for A/E services. - Assists with...

  • Sales Support Coordinator

    2 weeks ago

    Round Rock, United States OVIVO USA LLC Full time

    What is the Opportunity? At Ovivo, we offer you the opportunity to expand your skills and professional experience while collaborating with worldwide experts in water treatment. As a sales support coordinator you will support sales and promotional efforts that strengthen the sales department, enhance customer relations, and generate new opportunities....

  • Project Coordinator

    1 month ago

    Round Rock, United States Total Site Solutions Full time

    **Project Coordinator** **TSS seeks a highly motivated and dynamic individual to join our Round Rock, TX. team as a Project Coordinator. The Project Coordinator will support and assist the Project Management team working with operations to assist project setup, inventory planning, and deployment activities. Must be able multi-task and change direction...

  • Pharmacy Technician

    19 hours ago

    Paint Rock, United States Encompass Health Full time

    The Pharmacy Technician performs technical support functions in the department under the direct supervision of a registered pharmacist. Job Code: 100089 QualificationsLicense or Certification: - Certification and Registration as a Pharmacy Technician as required by the state. Total Education, Vocational Training and Experience: - Minimum 1 year experience in...

  • Pharmacy Technician

    1 day ago

    Paint Rock, United States Encompass Health Full time

    The Pharmacy Technician performs technical support functions in the department under the direct supervision of a registered pharmacist. Job Code: 100089 QualificationsLicense or Certification: - Certification and Registration as a Pharmacy Technician as required by the state. Total Education, Vocational Training and Experience: - Minimum 1 year experience in...

  • Insurance Verification/Billing Specialist

    1 month ago

    Little Rock, United States Pain Treatment Centers of America Full time

    Job DescriptionJob DescriptionDescription:SUMMARY OF RESPONSIBILITIESThe Patient Financial and Billing Representative is responsible for assisting patients with financial and billing inquiries. He/she is also responsible for running and providing accurate reports to multiple departments regarding a variety of data.ESSENTIAL FUNCTIONSThe Patient Financial and...

  • Project Manager/Licensed Project Engineer

    2 weeks ago

    Round Rock, United States Southwest Engineers, Inc. Full time

    Job DescriptionA Project Manager will lead a team of EIT’s, designers, and CAD Technicians to prepare construction plans, specifications, exhibits, reports, quantities, cost estimates, etc. for various land development projects.Coordinate with clients to understand scope of work and estimated hoursExpected to take ownership of projects from start to...

  • Project Manager/Licensed project Engineer

    1 month ago

    Round Rock, United States Southwest Engineers, Inc. Full time

    Job DescriptionA Project Manager will lead a team of EIT’s, designers, and CAD Technicians to prepare construction plans, specifications, exhibits, reports, quantities, cost estimates, etc. for various land development projects.Coordinate with clients to understand scope of work and estimated hoursExpected to take ownership of projects from start to...

  • Project Manager/Licensed Project Engineer

    5 days ago

    Round Rock, United States Southwest Engineers, Inc. Full time

    Job DescriptionA Project Manager will lead a team of EIT’s, designers, and CAD Technicians to prepare construction plans, specifications, exhibits, reports, quantities, cost estimates, etc. for various land development projects.Coordinate with clients to understand scope of work and estimated hoursExpected to take ownership of projects from start to...

  • Speech Language Therapist-SLP- Bel Air at Teravista

    21 hours ago

    Round Rock, United States Cantex Continuing Care Network Full time

    Job DetailsJob Location Bel Air at Teravista - Round Rock, TX DescriptionESSENTIAL FUNCTIONS: Screens, evaluates, and treats Patients. Evaluates Patient within one working days of physician referral. Completes a comprehensive evaluation using appropriate evaluation and assessment tools and procedures. Reviews patient records for current diagnoses, past...

  • Billing/Insurance Account Specialist

    3 weeks ago

    Little Rock, United States Alleviant Health Centers Full time

    Job DescriptionJob DescriptionAlleviant Integrated Mental Health is the largest full-service, multi-site outpatient psychiatry practice in Arkansas. In fact, we will see more than 70,000 Arkansans this year. We have become the primary referral source for many major systems in the state. We see all new patients within five days of connecting with them and...

  • Front Office Coordinator

    1 day ago

    Castle Rock, United States AMOS (Associates in Maxillofacial and Oral Surgery) Full time

    Description AMOS- Associates in Maxillofacial and Oral Surgery is a full-scope oral surgery practice. We are looking for an exceptional addition to our team. Our ideal candidate would like to join a team where they can grow in their career skills surrounded by a patient-centric team. Full-time employees are eligible for medical, vision, dental, disability,...

  • Sales Coordinator

    2 days ago

    Little Rock, United States Hotel Resource Full time

    **Sales** **Sales Coordinator** Sales Coordinator Concord Hospitality Little Rock AR **Sales Coordinator** **Company:** Concord Hospitality **Location:** 111 West Markham Street 72201 US **Category:** Sales **Degrees Required:** Not Specified **Employment Type:** Full-Time **Manages Others:** No **Requirements:** Now Hiring: Sales Coordinator ...

  • Sales Coordinator

    2 days ago

    Little Rock, United States Hotel Resource Full time

    **Sales** **Sales Coordinator** Sales Coordinator Concord Hospitality Little Rock AR **Sales Coordinator** **Company:** Concord Hospitality **Location:** 111 West Markham Street 72201 US **Category:** Sales **Degrees Required:** Not Specified **Employment Type:** Full-Time **Manages Others:** No **Requirements:** Now Hiring: Sales Coordinator ...

  • Registered Nurse

    4 weeks ago

    Round Rock, TX, United States US Oncology, Inc Full time

    Medical Oncology RN Texas Oncology is looking for a Clinic Registered Nurse (RN) to join our team!  This position will support the Medical Oncology Department at our 2410 Round Rock Avenue #150 location in Round Rock, Texas. This is a full-time Monday-Friday hours (8:30am-5pm) position with no weekends, call, or major holidays. Texas Oncology is...

  • Front Office Coordinator

    1 week ago

    Castle Rock, United States AMOS (Associates in Maxillofacial and Oral Surgery) Full time

    Description AMOS- Associates in Maxillofacial and Oral Surgery is a full-scope oral surgery practice. We are looking for an exceptional addition to our team. Our ideal candidate would like to join a team where they can grow in their career skills surrounded by a patient-centric team. Schedule: Monday, Tuesday, Wednesday, and Friday 7:30AM-5:00PM Full-time...

  • Coordinator Quotations Department

    1 day ago

    Little Rock, United States Graybar Full time

    Make a difference. Job Posting Description As a Coordinator - Quotations Department, you will support the Quotation Department and branch management, which has the overall responsibility to provide others with accurate and timely costing, quoting, pricing, and technical information based on customer specifications. You will conduct extensive research and...

  • Front Office Coordinator

    7 days ago

    Castle Rock, United States AMOS (Associates in Maxillofacial and Oral Surgery) Full time

    Job DescriptionJob DescriptionAMOS- Associates in Maxillofacial and Oral Surgery is a full-scope oral surgery practice. We are looking for an exceptional addition to our team. Our ideal candidate would like to join a team where they can grow in their career skills surrounded by a patient-centric team.Full-time employees are eligible for medical, vision,...

  • Travel Pharmacist in Little Rock, AR

    2 days ago

    Little Rock, United States AlliedTravelCareers Full time

    AlliedTravelCareers is working with CompHealth to find a qualified Pharmacist in Little Rock, Arkansas, 72076!About The PositionLarge Central Arkansas hospital has a need for a Pharmacy Tech to work flexible shifts. Certification is not required in this role and a High School diploma is sufficient. This role will support the pharmacy and the work will...

  • Client Manager of RCM Services

    4 weeks ago

    Little Rock, United States AAIT RCM Full time

    Job DescriptionJob DescriptionDescription:SUMMARY OF RESPONSIBILITIESThe Client Manager is responsible for managing the revenue cycle processes for physician practices and ambulatory surgical centers. The Client Manager will analyze the financial health on a monthly basis to identify reimbursement trends, patterns of denials, and develop an intimate...