Pharmacy Billing Specialist

4 days ago


Cerritos, California, United States LA BUSINESS MANAGEMENT SERVICES, LLC Full time
Pharmacy Billing Specialist

We are seeking a detail-oriented Pharmacy Billing Specialist to join our team at LA Business Management Services, LLC. The ideal candidate will have a background in pharmacy billing and payment posting and reconciliation.

Key Responsibilities:
  • Third-party insurance claim billing associated with dispensing medication and using the required bill method.
  • Transmit or submit claims to payors for reimbursement and reconciliations.
  • Resolve insurance problems and patient issues resulting from incorrect or incomplete information, therapy changes, and pharmacy or shipping errors.
  • Review payments received via check and research ability to convert to EFT.
  • Follow processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance, and documentation, as well as customer service and issue resolution.
  • Research and respond to payors regarding billing issues or recovery payments that are outstanding.
  • Assist in responding to audits from insurance companies.
  • Identify possible low payments based on trends and history.
Preferred Qualifications:
  • Previous experience in Pharmacy billing, specifically in payment posting, reconciliation, or related roles.
  • Experience using Microsoft Office products, specifically Excel, Outlook, and Word.
  • Insurance billing or collections experience.
  • Customer service in a healthcare environment.
  • Experience working in a healthcare reimbursement system.
  • Effective customer service skills and experience that shows ability to work in a team environment.
  • Attention to detail.
  • Ability to utilize analytical skills.
  • Ability to communicate with clientele in a professional manner; both verbally and written.
  • Strong attention to detail and accuracy in financial data entry.
  • Must be familiar with Insurance Bins and Pcn insurance Billing.
Skills and Competencies:
  • Must possess the ability to communicate with people at all levels of the organization and external agencies.
  • Must be very savvy with Microsoft products and capable of learning new software.
  • Must be able to create reports summarizing information using tables, charts, and/or graphs.
  • Must be open, agreeable, and professional when gathering and referring information to the appropriate member of the team.
  • Must have the ability to work alone but also in a team, with fellow staff, in the business setting. Must possess good time management skills.
Job Type:

Full-time

Expected Hours:

40 per week

Schedule:

Benefits:

  • Health insurance
  • Paid time off
Work Setting:

Office

Education and Experience Requirements:
  • High School Diploma or Graduation Equivalent Diploma (G.E.D)
  • Prior experience in a pharmacy or healthcare company.

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