Billing Specialist

2 days ago


Altoona, Pennsylvania, United States Value Specialty Pharmacy Full time
Job Summary

We are seeking a highly skilled Billing Technician to join our team at Value Specialty Pharmacy. As a key member of our Billing Department, you will play a critical role in ensuring the accurate and timely processing of claims, maintaining compliance with state and federal regulations, and providing exceptional customer service to our patients and payers.

Key Responsibilities
  1. Claims Processing: Gather data from patients, pharmacies, and insurance companies to complete claims processing, verify payer sources and insurance eligibility, and prepare and submit clean claims to various commercial insurance companies, Medicare Part D, and Medicaid.
  2. Claims Coordination: Process and understand claims coordination of benefits (COB) for secondary billing, identify and resolve problems related to third-party payers, and review clinical documentation to ensure compliance with Medicare guidelines.
  3. Customer Service: Provide exceptional customer service to patients and payers, respond to inquiries regarding claim denials or resubmissions, and build and maintain relationships with payee representatives.
  4. Administrative Tasks: Process daily and monthly invoices, maintain manufacturer reports, and submit data in accordance with data agreement timelines.
Requirements

To be successful in this role, you will need:

  • Knowledge of Insurance Procedures: A strong understanding of insurance procedures, billing requirements, and bookkeeping principles.
  • Computer Skills: Proficiency in computer software and systems, including calculator skills and expert customer service skills.
  • Communication Skills: Excellent written and oral communication skills, with the ability to understand and follow policies and procedures.
  • Time Management: Ability to meet tight deadlines and handle changing priorities and emergencies.
Work Environment

This position operates as a hybrid position with 40% of shifts on-site at our pharmacy location. The position has a high call volume and receives periodic supervision.

Security Clearance

A federal background check and drug screen are required for this position.



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