Pharmacy Billing Coordinator II

University of Maryland Medical System • Baltimore, MD

3d

About The Position

The Pharmacy Billing Coordinator II inputs and reviews billing information; prepares reports, tables, graphs and interprets results; and researches and reconciles billing problems in accordance with policy, procedure, and regulations. This role works with the health care team to ensure that patients can obtain authorization for treatments by utilizing and interpreting clinical information to complete authorizations and patient assistance program enrollments. The coordinator also completes complex insurance reconciliations when needed and manages and completes audits and payor requests ensuring that specialty patients have the necessary financial coverage and authorizations for both pharmacy and medical infusion treatments to begin, maintain, and complete treatment.

Requirements

• High School Graduate or equivalent.
• 5 years of experience.
• Pharmacy Leadership and/or specialty pharmacy and/or billing experience.
• Maryland Technician Registration OR Medical Assistant License.

Nice To Haves

• Some college.
• National Certification (CPhT).

Responsibilities

• Works to maximize optimum pharmacy revenue through pharmacy authorizations, appeals, and pharmacy claim reconciliation via customer and insurance payments.
• Communicates with insurance companies and health care providers and teams to ensure that patients have access to medications through optimizing insurances payments, coordination of benefits, copay assistance, financial and patient assistance programs.
• Investigates and addresses insurance issues including but not limited to billing issues and/or pharmacy authorizations on behalf of providers.
• Perform all other duties as assigned.

What This Job Offers

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