Billing Coordinator - Specialty Pharmacy
About The Position
The Billing Coordinator will manage adjudication inboxes, assist with medical claims billing, and troubleshoot orders with rejected statuses. This role is responsible for reconciling the master claims queue, assisting with billing projects, and ensuring accurate insurance information for correct adjudication. The coordinator will also help patients with copay card re-enrollment and patient assistance plans, communicate with these plans for payment, and assist with the initiation and resolution of prior authorizations. Collaboration with appropriate staff to resolve claims issues and adherence to company policies and HIPAA confidentiality guidelines are also key aspects of this position. Other duties as assigned may be part of this role.
Requirements
- High School Diploma or equivalent
- Certified and Registered Pharmacy Technician, (Colorado) in good standing required
- Registered with the State of Florida (Florida techs only) in good standing required
- Demonstrates a high degree of personal responsibility regarding accuracy and quality of work.
- Demonstrates ability to work effectively and maintain expected productivity.
- Ensures accuracy of information being provided to Management for review.
- Schedules own time based on priorities.
- Demonstrates Excellent customer service and Professionalism
- Ability to multi-task
- Ability to communicate effectively, patiently, and courteously.
- Ability to work in a high pace, stressful environment.
- Should be independent and self-motivated.
- Maintains a good attendance record.
Nice To Haves
- certification preferred (for Florida techs)
- Previous Prior Authorization or Claims experience is preferred
Responsibilities
- Manages the adjudication inboxes
- Assists with medical claims billing
- Responsible for troubleshooting orders with a rejected status; refill too soon, increase/decrease of dose, duplicate claim, and eligibility issues.
- Responsible for the reconciliation of the master claims queue
- Assist with billing projects, ie. Member AR report, COGS, etc.
- Ensures insurance information is accurate for correct adjudication.
- Assists patients in the re-enrollment of copay cards and patient assistance plans
- Communicates with patient assistance plans when necessary to obtain payment
- Assists with the timely initiation and resolution of prior authorizations
- Works with appropriate staff members to resolve claims issues
- Follow and aid in enforcement of all company policies and procedures.
- Respect and maintain confidentiality guidelines of HIPAA.
- Responsible for other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
