Pharmacy Billing Specialist
4 weeks ago
The Pharmacy Billing Office Specialist position is responsible for preparing, verifying, correcting, and submitting electronic insurance claims, resolving complex billing issues, coding, and posting entries into the Pharmacy patient accounting system to ensure accurate and expedient processing of general accounting, accounts payable, accounts receivable, or other financial documentation.
Key Responsibilities- Ensure patients are registered in the Pharmacy patient accounting system and billed with the appropriate payor type.
- Review claims for accuracy, perform required edits, submit claims, and rebill to payors daily in electronic format to ensure accurate and timely filing of claims and prompt payment.
- Request additional information from patients, insurance carriers, Pharmacy staff, and other Cantex departments to make corrections to claims.
- Receive and post assigned payment batches to the appropriate patient account or facility account from checks or remittance advice using the appropriate payment/adjustment code to ensure accurate and timely posting of receipts.
- Makes appropriate corrections such as changing payor types, updating payor information, and/or changing the priority of the payor accounts to ensure payments are posted accurately.
- Accumulate and provide data/documents for maintenance of accounts payable, accounts receivable, and payroll ledgers.
- Prepare and deliver bank deposits.
- Compile data and provide cumulative reports on a daily, weekly, or monthly basis as required by departmental Supervisor, Manager, and/or Director of Pharmacy.
- Answer incoming calls in a timely manner.
- Maintain appropriate inventories of various office supplies and forms.
- Maintain knowledge of applicable rules, regulations, policies, laws, and guidelines that impact billing, collections, and payors.
- Adhere to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.
- Actively participate in Business Office or Pharmacy meetings.
- Seek advice and guidance as necessary to ensure proper understanding.
- Responsible for assuring patient/resident safety.
- Perform other duties and tasks as assigned.
- A high school diploma is required; a college degree or equivalent advanced courses in office management are preferred.
- Prior pharmacy billing experience to include two (2) years of payment posting, billing, and/or collections experience is required.
- Computer literacy is required.
- Proficiency in math and language usage is expected.
- Must be able to handle potentially stressful situations and multiple tasks simultaneously.
- Ability to read, write, and speak the English language is required.
Cantex is an Equal opportunity employer. We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance plans as well as a Highly competitive compensation package. Diversity, Equity, and Inclusion are at the heart of Cantex. We are committed to a culture that respects our differences and values the contributions of all people.
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