Pharmacy Pre-Billing Specialist

CSI Companies•Nash, TX

6d•Onsite

About The Position

This position will be responsible for reviewing the quality of work produced by the referral management and intake teams. Information and materials generated from these departments will be for final review by the Intake Director and Quality Control Coordinator. Including, but not limited to, verification of customer insurance, healthcare claim submissions, PDP and Medical prior authorizations, and other related work produced. Direct communication with insurance organizations may be required. Essential Duties and Responsibilities include the following. Other duties may be assigned, as necessary.

Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Provides the highest level of professionalism, responsiveness, and communication to build and maintain the maximum customer base possible.
Possesses the ability to multi-task and frequently change direction as required.
A High School Diploma or equivalent GED is required, at minimum.
3 - 5 years medical experience.
Ability to work independently and within a multidisciplinary team.
Minimum two years in healthcare environment/industry

Nice To Haves

College or technical college preferred

Responsibilities

Reviews insurance operational areas: Insurance Verification and entry into Care Tend Prior Authorization completion in CT Preparation for Claim Submission Intake Workflow Copay Assistance / billing Insurance software
Performs a variety of office functions, such as filing, typing, copying, data entry, research, etc., to support various b Maintains various Billing files in proper order billing and financial operations.
Nursing Software/Nursing Note Submission & Nurse tracking.
Billing preparations for nursing notes
Adheres to confidentiality, safety, compliance, and legal requirements.
Ongoing Communication with Referral Management, Billing, Insurance Verification, and Data Entry.
Assists in appropriate product selection by understanding all payers, reimbursement, and formularies.
Comply with company deadlines and inventory to meet both the company and its compliance standards.
Consistently represents the company in a professional manner.
Maintains effective working relationship and cooperates with all personnel in the Company.
Participate in administrative staff meetings and attend other meetings and seminars.
Performs other related duties as assigned or requested.