Pharmacy Billing Coordinator
San Ysidro Health•San Diego, CA
•$26 - $33•Hybrid
About The Position
Responsible for review, interpreting and posting of Pharmacy Benefit Manager payments. Payment posting is a data entry position in a high production-based environment with time sensitive deadlines. Accurate application of payments is needed and attention to detail.
Requirements
- High School Diploma or GED equivalent.
- Minimum 2 years with claim adjudication/billing experience.
- Ability to organize and prioritize work to meet deadlines.
- Good oral and written communication skills.
- Prolonged periods of sitting using a PC and constant walking and standing.
- Lifting no more than 15 lbs.
- The ability to follow directions correctly and accurately is a must.
Nice To Haves
- Current Pharmacy Technician license from CA Board of Pharmacy preferred.
- 2 years of relevant medication prior authorization experience preferred.
- At least some familiarity with EPIC.
- Bilingual (English/Spanish preferred.
- Knowledge of MediCal, Medicare and commercial insurance regulations preferred.
- Knowledge of medical terminology and familiarity with Epic systems preferred.
- Driving and occasional travel to other sites may be required.
Responsibilities
- Reviews patient and prescription data in the pharmacy system.
- Reviews claim submission for accuracy.
- Review and Post payments in Pharmacy Benefit Manager portal.
- Verify Deposits in Pharmacy Benefit Manager portal.
- Download 835 files from Pharmacy Benefit Manager portal.
- Organize and upload 835s to Epic FTP folder.
- Load and post bank cash files.
- Performs accurate posting of payments and denials.
- Applies adjustments according to carrier’s adjudication and/or SYH posting procedures and contracts.
- Reviews and clears errors on payments.
- Coordinates the preparation of reports and written documentation, as required by the department.
- Follows established departmental policies and procedures, quality assurance program, safety, environmental and infection control standards.
- Enhance professional growth and development through participation in educational programs, current literature, in-service meetings and workshops.
- Review and submit prior authorizations as needed.
- Performs other related duties as assigned by the Director of Pharmacy or Pharmacy Business Supervisor.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
