Collection Specialist Pharmacy

2 weeks ago

Omaha, United States Amber Specialty Pharmacy Full time

At Amber Specialty Pharmacy, our commitment to patient care is unmatched. Enjoy fulfillment in a career where you have the opportunity to make a positive impact on patients with complex and chronic conditions.

This position ensures proper insurance payment collection from carriers for medical and pharmacy coverage and locates financial resources to assist patients with chronic, life-altering conditions. Our teams look at solutions for patients.

Monday -Fridays -

Hours: 8:00 am to 5:00 pm

In office position

No weekends

Wages: $19.27$24.08 based on direct experience

Post-offer, Pre-hire successful candidates must pass a drug screen, health screen (if applicable to the role), and background check.

Amber Specialty Pharmacy

Job Title: Collection Specialist

Department: Claims/Billing

FLSA: Non-Exempt

General Functions:

The Collection Specialist ensures accurate insurance information is received and stored. They gather all information required to bill electronic NCPDP claims in the appropriate order in the event of multiple payers and review statements to determine accuracy. Collections Specialists help navigate financial assistance programs to help patients gain financial support. Communicating with coordinators and co-workers regarding insurance verification and promoting exceptional customer service and professionalism with the community is key in this position.

Reporting Relations:

Reports to: Lead Collection Specialist

Direct Reports: None

Primary Duties and Responsibilities:

  • Consults with patients to resolve all types of payer and coverage issues
  • Contacts the patient, when necessary, to gather insurance and billing information or notify of a delay in processing
  • Conducts a benefits investigation, updates patient accounts, prescriptions, etc.
  • Collects on outstanding patient balances
  • Processes adjudication rejections, insurance terminations, and insurance changes
  • Handles patient benefit statement questions to a conclusion
  • Researches and reviews patient inquiries on account balances
  • Conducts welcome calls for new transplant patients
  • Knows Amber HIPAA policies and maintains patient confidentiality at all times. Works as a team member with all other departments to verify benefits
  • Working knowledge of all necessary computer software to perform job duties
  • Bills claims via electronic NCPDP clearinghouse and/or Medical
  • Works claims in the clearinghouse to ensure our payers receive them
  • Responsible for aiding in accounts receivable by billing claims correctly and getting them to our payers on time
  • Works with team to achieve company AR goals
  • Understanding of payer contracts and how claims should be submitted to each payer
  • Follows up on claims to ensure receipt by the payer
  • Bills secondary claims and ensures timely filing limits are not exceeded
  • Ensures that payer guidelines are followed for processing claims
  • Follows up with Pharmacy and Medical Billing Specialists to make sure all changes are addressed
  • This is an office-based position
Professional Competencies:
  • Proficient with MS Excel, Word, and Outlook Strong
  • Oral, written, organizational, and interpersonal skills
  • Demonstrated ability to meet tight deadlines
  • Ability to work in a team and with all levels of internal management and staff, as well as outside clients and vendors
Educational and Experience Requirements:
  • High school diploma or equivalent
  • Working knowledge of the healthcare industry
  • HIPAA trained and /or the ability to work with and protect highly confidential patient and employee information
  • One (1) year of experience billing electronic insurance claims, including; Medicaid, Medicare, and Commercial insurance via NCPDP clearinghouse. Medical billing experience preferred
  • Experience working with clearinghouses for claim adjudication
  • Six (6) months to one-year phone-based customer service
Physical Requirements:
  • Must be able to remain in a stationary position up to 90% of the time
  • The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc., and traverse conferences, meetings, and remote events
  • Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer
  • The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations
  • The ability to observe details at close range (within a few feet of the observer)


Working Conditions:

Normal office environment.

Equipment Used to Perform the Job:

Computers, keyboards, mouse, monitors, fax, and/or headsets for phone work. Software specific to the position, including but not limited to Microsoft Outlook and Skype. Must lift and traverse the area to move paper and supplies to use the equipment.

Contacts:

Frequently interact with co-workers, intradepartmental staff of the Company, managers, leaders, Vendors, and customers.

Confidentiality:

The position Interactions with medical personnel, patients and accesses proprietary and medical (HIPAA) information in various interactions and matters.

Apply now and join our mission to provide exceptional patient care

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