Medical Billing Specialist

3 days ago


Louisville, Kentucky, United States BrightSpring Health Services Full time

Job Summary

We are seeking a highly skilled Medical Billing Specialist to join our team at PharMerica. As a key member of our revenue cycle operations, you will be responsible for ensuring the accurate and timely adjudication of prescriptions, onsite training of new hires, and maintenance of pharmacy unbilled claims.

Responsibilities

  • Ensure the accuracy and timely adjudication of resident billing and re-billing through Medicare Part B & D, Medicaid, Hospice, and Private Insurance Plans.
  • Daily, weekly, and monthly review and resolution of unbilled claims.
  • Review monthly billing statements for facilities to ensure billing accuracy.
  • Claim research and resolution.
  • Partner with facility contacts when there are issues with claim processing in order to achieve adjudication/payment.
  • Advocate for clients as needed.
  • Communicate with insurance companies as needed.
  • Support for Pharmacy Operations.
  • Utilize Framework, Docutrack, and Fusion in order to complete workflow on daily basis.
  • Provide onsite training for new hires.
  • Assist Implementation Coordinator with integration of new facilities/clients as needed.
  • Handle core billing responsibilities with newly gained contracted facilities onboarding with Pharmacy Alternatives.
  • Maintain and update the Billing Training Manual.
  • Perform other responsibilities as assigned.

Requirements

  • High School Diploma/GED required.
  • Pharmacy Tech License preferred.
  • Excellent customer service and communication skills, both written and verbal.
  • Ability to prioritize and meet pre-determined deadlines.
  • Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills.
  • Experience in healthcare billing environment (pharmacy preferred).
  • Familiarization with online claims processing and Medicaid and Medicare billing practices.
  • Proficient with Microsoft Word and Excel required.

About Our Company

PharMerica is a full-service pharmacy solution providing value beyond medication. We offer a competitive salary range of $17.00 per hour, along with a comprehensive benefits package that includes health, dental, vision, and life insurance, as well as paid time off and tuition reimbursement.



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