What are the responsibilities and job description for the Hybrid Insurance and Billing Specialist position at DirectRx?
Elevate Patient Care with DirectRx Pharmacy!
DirectRx Pharmacy is recognized as one of the Top 100 Best Places to Work in Michigan and serves a growing patient population nationwide. We're looking for an Insurance and Billing Specialist to support patient access, coverage navigation, and accurate billing as part of our patient care operations.
In person training is required, then remote schedule following completion of 3 month training
Position Overview
The Insurance and Billing Specialist plays a key role in supporting patient access and continuity of care. This role works closely with patients, providers, and payers to verify benefits, submit and resolve claims, reconcile accounts, and help remove financial barriers to therapy.
Major Duties and Responsibilities:
- Support patient access and adherence to therapy by conducting insurance verifications, navigating benefits and coverage limitations, reviewing medical records for required diagnostic criteria, and determining need and eligibility for patient assistance programs
- Ensure successful patient outcomes through daily operational and clinical collaboration
- Accurate referral and account setup with all required data elements to ensure compliance standards are met
- Claim preparation and submission, patient payment collection, and denial management
- Timely management of billing assignments and patient account reconciliation
- Daily queue organization to ensure seamless onboarding and continuity of care
- Engage in comprehensive communication with both patients, providers, and insurers regarding therapy, coverage, and financial concerns.
Key Competencies:
- Desire to learn and grow in a fast-paced environment
- Robust personal responsibility and capacity to problem solve, multitask, and collaborate cross-functionally
- Excellent written and verbal communication skills
- Demonstrated commitment to superior quality and performance
Education and Experience:
- Minimum one year of direct medical billing experience and/or Medical Billing certification required
- Knowledge of medical billing policies, procedures, and requirements preferred
- High school diploma required
Join DirectRx Pharmacy, where you'll be a part of a top-tier healthcare provider, serving over 30,000 active patients, and contributing to our mission of excellence. Become an integral part of our patient care team as we shape the future of healthcare together.