What are the responsibilities and job description for the Third Party Billing Specialist Pharmacy position at Erica Loren Spa?
Hours: Monday thru Friday 2:00pm to 10:30pm EST
$20-25
Can be remote or on site
The Third-Party Billing Representative will be responsible for, but not limited to:
As the Third-Party Billing Representative, your responsibilities will include preparing accurate invoices, collecting, and processing payments on claims, reconciling accounts, maintaining knowledge of current policies & procedures, verifying services are authorized and appropriate, and assisting customers with inquires via telephone.
Ensure that all required third party insurance settings are coded and maintained appropriately within the pharmacy adjudication system
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Perform extensive testing and documentation to ensure accurate prescription claims processing while remaining in compliance with pharmacy standards and payer requirements
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Analyze third party claim rejection and investigate and resolve systemic issues relative to prescription claims processing that interface with claims being able to be process
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Working with the Facility in suppling nonfiction on rejected claims, with the third-party workflow that has been created to comply with the facility standards, contract agreements and state and federal regulations
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Working with Pharmacy Application Development teams in Information Systems (IS) to provide prescription claims processing support for all system related issues or enhancements including defining business scenarios and testing procedures, analyzing production issues for any potential causes, and recreating all known defects in test environments to assist development
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Working cross-functionally within the department to provide quality assurance within Pharmacy Operations by executing various scenarios affecting data quality, prescription claim processing and providing in-depth analysis of the results
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Ability to work independently under pressure and pre-set deadlines in accurate manner with consistently high production
Education:
High School Diploma or equivalent
PTCB- Pharmacy Technician Certification Board License
Professional Experience:
- Experience in long term care or retail pharmacy environment
- 1-3 years of Third-Party Billing experience
- Experience in Framework, DocuTrack, a plus.
- Communication, problem solving and organizational skills a must
- Must be able to work in a fast-paced environment and meet deadlines
- Typing, computer and multi-tasking skills are a must
- Experience resolving insurance rejections codes
- Experience calculating day supplies
- Knowledge of sig codes
Job Type: Full-time
Pay: $20.00 - $25.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Physical setting:
- Office
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: Remote
Salary : $20 - $25