Billing Specialist
About The Position
The Billing Specialist supports pharmacy operations by performing activities that do not require a pharmacist’s professional judgment. The role is primarily responsible for billing pharmacy and medical claims and adjudicating rejections. The position is hybrid, with three days onsite and two days remote after three months of onsite training. The stated training schedule is Monday through Friday, 8:30 a.m. to 5:00 p.m.; after training, the schedule includes one opening shift, two mid-shifts, and two closing shifts per week. Associates working evening hours after 6 p.m. are eligible for a shift differential. Onsite attendance is required at the Williamsville location.
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.
- Examples of displaying the 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, manage rejections, ensure appropriate follow-up, and meet delivery promise times.
- 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 Reliance Rx follows CMS guidelines and Medicare and Medicaid guidance.
- 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 the financial aspects of claims before they leave the facility.
- Manage the patient portal, including refill reminders, processing portal orders, and patient registrations.
- Coordinate financial assistance with patients for foundation care, copay assistance, or free medication programs when applicable.
- Assist Patient Care Specialists with workflow and incoming and outgoing calls according to business needs.
- Maintain patient records and perform filing and documentation duties.
- Complete setup and data entry.
- Arrange financial agreements and collect copayments.
- Assist offices with prior authorizations.
- Coordinate benefits.
- Promote information sharing and continuous process improvement.
- Follow standard written procedures and guidelines, with deviations approved by the supervising pharmacist.
Benefits
- Associates may be eligible for a scorecard incentive.
- Full range of benefits.
- Generous paid time off.
- Shift differential for associates working evening hours after 6 p.m.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
