Pharmacy Billing Specialist

Devereux • Worcester, MA

1d • Hybrid

About The Position

Are you an experienced Claims Specialist who is a compassionate team collaborator who puts people first, shows care and concern for all and enjoys the challenge of following, resolving and reconciling third party claims and contributing to pharmacy business? Do you consider yourself a self-starter with excellent interpersonal, communication and customer service skills? Do you want to join an organization that is focused on Servant Leadership? If you answered YES to any of these questions, then we invite you to bring your “roll-up-your sleeves and get the job done” attitude and commitment by joining our Devereux Advanced Behavioral Health team! Being a Pharmacy Claims Specialist has its Advantages In this role, you will collaborate with other dedicated professionals, internally and externally, who share your passion for helping individuals in need. We offer: A unique opportunity where the work you perform will support Devereux’s National Center and Centers throughout the country with pharmacy related claims, resulting in contributions that have relevance to the provision of services to individuals; A Supportive team collegial work atmosphere with the ability to deliver high-quality Financial support data driven decisions; Salary Range: $17.22 to $19.64 Quality Health Pharmacy (QHP), a division of Devereux, was founded at our Texas Center in 1992. In response to the evolving needs of our more than 15 centers nationwide, we continue to grow and strengthen our pharmacy program. Today, Devereux operates pharmacy programs in Cherry Hill, NJ; Orlando, FL; and League City, TX. Under the guidance of the Vice President for Pharmacy, this role will provide billing support to Worcester and the surrounding communities, upholding processes and procedures that align with best practices, as well as all applicable regulatory, accreditation, and professional pharmacy standards.

Requirements

• High School Diploma or G.E.D.
• Computer proficiency in the Microsoft Office products
• Strong customer service skills and team player with the ability to adapt to change and work effectively in a cross-functional team environment
• Multi-tasker with ability to meet deadlines
• Valid driver’s license and car is required

Nice To Haves

• Some college coursework is highly preferred
• Pharmacy Technician Certification is preferred
• Minimum of three years of experience in pharmacy and/or performing Pharmacy insurance billing and collection duties is preferred
• Pharmacy pricing and medication knowledge is preferred

Responsibilities

• Perform timely preparation and electronic submission of claims to third party carriers and guarantors
• Perform utilization review and correction of rejected claims, answering inquiries on a timely basis
• Complete and submit other pharmacy documents and paperwork, e.g., electronic records, reports, monthly medication charge and usage reports
• Assist in setting up contracts, Medicaid applications and renewals
• Communicate with all funding agencies, including private payers, regarding claim processing procedures and payment difficulties
• Prepare and disseminate information requested by government agencies and external auditors
• Research all non-applied credit line items
• Perform system integrity checks and maintenance and coordinate and respond to internal and external audit requests

Benefits

• A comprehensive health and welfare program
• Medical (including telemedicine via phone, web, app), dental, prescription drug, preventative care, and mental health services
• Student loan debt assistance
• Tuition reimbursement and continuing education assistance
• Generous time-off (start accruing 1st day)
• 403(b) retirement plan with matching benefit
• Voluntary/employee paid supplemental life and accident coverage
• Employee assistance / work-life balance program

What This Job Offers

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