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Pharmacy Billing Specialist

2 months ago

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

We are seeking a detail-oriented Pharmacy Biller Reconciliation 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:
  • Process third-party insurance claims associated with medication dispensing and utilize the required billing method for each payer.
  • Submit claims (paper/electronic) to payors for reimbursement and reconcile payments.
  • Resolve insurance and patient issues resulting from incorrect or incomplete information, therapy changes, and pharmacy or shipping errors.
  • Review payments received via check and research the ability to convert to Electronic Funds Transfer (EFT).
  • Follow established 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 experience in a healthcare environment.
  • Experience working in a healthcare reimbursement system.
  • Effective customer service skills and experience working in a team environment.
  • Attention to detail and ability to utilize analytical skills.
  • Ability to communicate with clients in a professional manner, both verbally and written.
  • Strong attention to detail and accuracy in financial data entry.
  • Familiarity with Insurance Bins and PCN insurance billing.
Skills and Competencies:
  • Ability to communicate with people at all levels of the organization and external agencies.
  • Proficiency in Microsoft products and ability to learn new software.
  • Ability to create reports summarizing information using tables, charts, and/or graphs.
  • Open, agreeable, and professional demeanor when gathering and referring information to the appropriate team member.
  • Ability to work alone and in a team, with fellow staff, in a business setting. Good time management skills.
Job Type:

Full-time, 40 hours per week.

Benefits:
  • Health insurance.
Work Setting:
  • Office.