Pharmacy Billing Specialist (Claims Resolution/Denials)

Indiana Hemophilia & Thrombosis Center • Indianapolis, IN

2d

About The Position

At the Innovative Hematology (IHI), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families. As a Pharmacy Billing Specialist, you will be responsible for pursuing the appropriate and timely collection of all claims for payment for pharmacy services.

Requirements

• High school diploma or GED
• Minimum 3 years of experience in hospital or medical setting

Responsibilities

• Assist in the preparation and submission of pharmacy claims to third party insurance carriers, if and when necessary.
• Secure appropriate medical documentation as required by third party insurance carriers.
• Follow up with third party insurance carriers and patients on unpaid claims or balances.
• Research payer regulations and claim guidelines regarding claim payment and denial management criteria to ensure compliant billing practices by utilizing website and associated tools established by payers as applicable.
• Assist in verification of insurance coverage for pharmacy services prior to services being rendered, if applicable.
• Re-verify benefit coverage criteria as needed for claims follow up.
• Ensure accurate and thorough documentation of steps taken to resolve claim issues are recorded in billing software(s).
• Communicate claim issues to Billing Manager on a regular basis.
• Work with Billing Manager to establish weekly, monthly, annual goals and communicate associated progress as needed.

Benefits

• IHI is a not-for-profit program based in Indianapolis and offers a competitive salary and benefit package.
• IHI is the only ederally designated comprehensive hemophilia program in Indiana, and serves the entire state through services available in Indianapolis and at outreach clinics.
• IHI is a leader in hemophilia care, education and clinical research and has a dedicated on-site multidisciplinary staff to ensure availability of a wide range of required services.
• IHI participates in national and international clinical research, including new infusion products and therapies, investigation of long-term outcomes, and the impact of associated conditions.
• The IHTC research program provides patients access to new therapies, and an opportunity to improve care.
• Our center has more than 70 clinical research projects involving bleeding disorders, sickle cell disease, thrombosis and more.
• The Indiana Hemophilia and Thrombosis Center is an Equal Opportunity Employer.

What This Job Offers

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