Billing Specialist

Independent Health Association • Buffalo, NY

8d • Hybrid

About The Position

The Billing Specialist supports pharmacy operations by completing billing for pharmacy and medical claims and adjudicating rejections. The role handles patient and payor communication, claim accuracy, delivery setup, portal orders and registrations, and financial assistance coordination. It also supports Patient Care Specialists with workflow, calls, record maintenance, documentation, data entry, financial arrangements, prior authorizations, and coordination of benefits. The position follows written procedures and guidelines, with deviations approved by the supervising pharmacist. This is a hybrid position requiring onsite attendance at the Williamsville location. Immigration or work visa sponsorship is not provided.

Requirements

• High school diploma or GED.
• One year of experience working in a high-volume pharmacy or equivalent setting, or six months as a temporary associate in the Reliance Rx Operations & Compliance department.
• Effective oral and written communication skills.
• Aptitude for working with other health care professionals.
• Ability to lift a minimum of 5 lbs.
• Demonstrated examples of Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive.

Nice To Haves

• National Pharmacy Technician Certification (CPhT).
• Experience working with an online claims processing system.

Responsibilities

• Bill pharmacy and medical claims and manage rejections, ensuring appropriate follow-up and delivery promise times are met.
• Act as a liaison between patients and insurance companies and facilitate communication among patients, doctors, medical staff, and administrative staff.
• Work with payors to resolve billing issues.
• Ensure compliance with CMS guidelines for Medicare and Medicaid.
• Confirm billing accuracy and payor billing and shipping requirements.
• Process and set up deliveries to medical offices.
• Bill medical claims for supplies and medications.
• Confirm financial aspects of claims before they leave the facility.
• Manage the portal, including refill reminders, processing portal orders, and completing patient registrations.
• Coordinate financial assistance with patients, including foundation care, copay assistance, and free medication programs where applicable.
• Assist Patient Care Specialists with workflow and incoming and outgoing calls according to business needs.
• Maintain patient records and complete filing and documentation duties.
• Perform setup and data entry.
• Arrange finances and collect co-payments.
• Assist offices with prior authorizations.
• Coordinate benefits.
• Promote information sharing and continuous process improvement.
• Follow standard written procedures and guidelines; obtain supervising pharmacist approval for deviations.

Benefits

• Full range of benefits
• Generous paid time off
• Associates may be eligible for a scorecard incentive

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED