Pharmacy Billing Coordinator, Enterprise

Kindbody

About The Position

As an experienced Billing Coordinator for pharmacy accounts, you will be working in a fast-paced, rapidly growing environment where you will be relied on for your expertise, professionalism, and collaboration. We are looking for a dedicated professional to join our team to support our clinic and operations team. This role will greatly emphasize customer relations- you must be comfortable interacting, communicating, and working directly with patients and pharmacy staff.

Requirements

2+ years of healthcare experience in a fast-paced, customer-focused environment, Fertility financial experience, and pharmacy a plus
Strong written and verbal communication skills & a team player
Willingness to be flexible, roll with the punches, multi-task, and troubleshoot problems
Detail-oriented with strong organizational skills
Exemplifies amazing customer service skills and professionalism
Experience in CPT and ICD-10 coding; familiarity with medical terminology
Ability to manage relationships with various insurance payers
Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
Certificate from an accredited medical and billing school.

Nice To Haves

A passion for women’s health, and fertility is a plus

Responsibilities

Daily communication with the pharmacy regarding patient demographic details and prescription orders
Work in conjunction with pharmacy to invoice patients and daily reconciliation of prescriptions
Entry of billable items into the practice management system
Handle patient intake phone calls and email inquiries, review light clinical information, and review in-network insurance information with the patient
Verify patient eligibility and benefits and provide details
Review of orders with patients to include employer benefit coverage and out-of-pocket responsibilities
Respond to and complete internal communication flags of patients needing to be contacted or problems that need to be resolved.
Answer any incoming patient emails on financial matters, triaging any non-financial needs or questions
Maintains current knowledge in pharmacy billing requirements related to employer/third-party
Effective communication abilities for phone contacts with insurance payers to resolve issues
Customer service skills for interacting with patients regarding medical claims and payments
Research and resolve any discrepancies, denials, appeals, collections
Set up patient payment plans and work collection accounts
Review patient bills for accuracy and completeness and obtain any missing information
Process claims and post payments.
Process insurance payments, including balance billing to secondary insurance and/or directly to patients.
Ensure timely follow-up on all unpaid claims utilizing monthly aging reports
Analyze rejected and outstanding claims, troubleshoot errors and rejection codes, and correct and re-submit all denied claims.
Properly note the system and maintain all documentation required for compliant claim submission.
Prepare and process refund requests.
Verify and post patient amounts.
Respond to a high volume of telephone inquiries in a positive and professional manner, and resolve and follow up on all issues within designated timeframes.
Meet positional metrics and benchmarks.
Maintain the highest degree of ethics when handling patient payments and bill processing
Follow all department standard operating procedures carefully and accurately
Other duties as assigned by the Director.
Manage inbound customer communication (phone, email & chat) and ensure all messages are answered in a timely fashion
Maintain clear communication with the clinics about overall clinic operations
Other duties and projects as assigned