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Job Summary
The Pharmacy Billing Specialist will be responsible for processing and adjudication of prescription claims to third party payers in a high-volume setting.
Resolution of denials through communication and coordination with PBMs, MHA, insurance providers, clients, and patients will be necessary to facilitate this process.
The Pharmacy Billing Specialist will initiate prior authorizations and assist providers in submitting the necessary documentation for approval.
They will also be responsible for periodic review and correction of claim submissions throughout the pharmacy. The Pharmacy Billing Specialist will play an integral role in the daily operations at Terrapin and will work with individuals in various departments within the pharmacy.
The ideal candidate will be self-sufficient and able to work in a fast-paced and changing environment.
Main Responsibilities
ProcessingAdjudication (60% )
Prior Authorizations (20%)
Claims Review (20%)
Minimum Qualifications
Physical Requirements
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions in this job description :
Hopeful - We believe in the power of the human spirit, that every person matters, and we find a way to say yes.
Ethical - We do what is right with honesty, integrity, and transparency.
Accountable - We take ownership of problems, welcome feedback, and seek continuous improvement.
Respectful - We treat every person with kindness and listen with an open mind.
Team-oriented - We put clients and providers first, act with humility, and work together for the well-being of others.
Benefit summary / EEOC Statement / Drug-Free and testing - Altruix offers a competitive salary and a comprehensive benefit package which includes medical, dental and vision plans through CareFirst (a Blue Cross Blue Shield plan);
employer paid long-term disability coverage and life insurance; an employer matched 401K plan; paid time off and paid holidays.
Altruix is an Equal Opportunity Employer and does not discriminate in recruiting, hiring, placement, training, promotion, termination, layoff, recall, transfers, leaves of absence, compensation, and other employment practices on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, genetic information, disability status, protected veteran status, or any other trait protected by federal, state, or local laws.
Altruix is a drug-free work environment and requires pre-employment drug and alcohol testing as a condition of employment .
Last updated : 2024-04-28
Full Time
$48k-63k (estimate)
04/27/2024
06/26/2024
The job skills required for Billing specialist include Billing, Data Entry, Communication Skills, Coordination, etc. Having related job skills and expertise will give you an advantage when applying to be a Billing specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Billing specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Billing specialist positions, which can be used as a reference in future career path planning. As a Billing specialist, it can be promoted into senior positions as a Billing Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Billing specialist. You can explore the career advancement for a Billing specialist below and select your interested title to get hiring information.
If you are interested in becoming a Billing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Billing Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Billing Specialist job description and responsibilities
Billing specialists prepare comprehensive and precise reports.
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Review documents like purchase orders, sales tickets, charge slips, or hospital records to compute fees or charges due.
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billing specialists, which are also known as billing clerks, handle the payments and processing for doctors and patients.
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Prepares, generates and mails, via computer database, patient and third party payers’ billing statements.
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A billing specialist will need to learn quickly and pick up whatever new skills are necessary.
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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Billing Specialist jobs
Find relevant Billing Specialist jobs, and apply.
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Communicate as efficiently as possible.
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Make checklists and to-do lists.
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Teach calendar and time management skills.
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Look for Training and Learning Opportunities.
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Step 3: View the best colleges and universities for Billing Specialist.