Billing Technician – Remote Position Job Vacancy in Value Specialty Pharmacy Duncansville, PA 16635 – Latest Jobs in Duncansville, PA 16635

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Company Name : Value Specialty Pharmacy
Location : Duncansville, PA 16635
Position : Billing Technician – Remote Position

Job Description : Support the Billing Department and Billing Manager and Reimbursements in a variety of tasks in compliance with state and federal laws and regulations as well as company policies.
Essential Functions
1. Gather data from patients, pharmacies and insurance companies to complete claims processing
2. Verify payer sources and insurance eligibility
3. Prepare and submit clean claims to various commercial insurance companies, Medicare Part D, and Medicaid using both electronic and paper submission methods
4. Process and understand claims coordination of benefits (COB) for secondary billing
5. Contact insurance companies to make inquiries regarding claim denials or resubmissions
6. Identifies, researches, and resolves problems related to third party payers
7. Review clinical documentation to ensure compliance with Medicare guidelines
8. Identify and validate ICD-10 codes and HCPC Codes as appropriate for products dispensed through pharmacy claims and medical claims
9. Process daily and monthly invoices
10. Process and maintain manufacturer reports and submit in accordance with data agreement timeline
11. Process and maintain data on Maximum Allowable Cost appeals (MAC) to obtain the most accurate pricing through payers
12. Review and interpret EOBs for claim collection and follow up
13. Reconcile payments from payers, post adjustments and credits to patient accounts
14. Participate in third party and Medicare claim audits to minimize financial discrepancies
15. Assist with medical claims processing to ensure proper documentation and patient information to process clean claims
16. Process credit card transactions daily and apply payments
17. Assist with patient financial assistance through foundations
18. Assist pharmacy staff with all electronically adjudicated claims to ensure prescriptions are reconciled and paid for prior to delivery
19. Build and maintain relationships with payee representatives
20. Protect patient confidentiality, according to HIPAA guidelines
21. Attend at all meetings, conference calls, off site meetings etc. at the discretion of Billing Manager
22. Other duties as assigned
Work Environment
This position operates as a remote position with occasional on site at pharmacy location if needed. Position has a high call volume and receives periodic supervision.
Competencies
Knowledge of insurance procedures, billing requirements and bookkeeping required. Requires computer and calculator skills, expert customer service skills, ability to understand and follow policies and procedures, written and oral communication proficiency, accuracy, time management, teamwork, collaboration skills, organizational skills, expert telephone skills, ability to handle frequent interruptions, and email skill. Ability to meet tight deadlines and handle changing priorities and emergencies.
Physical demands typical of this position
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit or stand for long periods of time, walk, use hands and fingers to operate a computer keyboard, mouse, and other computer or office equipment. Visual acuity to read printed material and a computer screen and ability to concentrate. May require bending, climbing and occasional lifting of up to 30 lbs.
Supervisory Responsibility
N/A
Travel
N/A
Preferred Education and Experience
Retail pharmacy experience and/or experience with medical and pharmacy billing
Security Clearance/Background Check
Pass a federal background check, child abuse clearance, TB test, and drug screen.
AA/EEO Statement
If required.
Other Duties
This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.
This job description has been approved by all levels of management.
Experience
Preferred
Experience with medical and pharmacy billing
Retail pharmacy experience
Behaviors
Preferred
Team Player: Works well as a member of a group
Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
Dedicated: Devoted to a task or purpose with loyalty or integrity
Motivations
Preferred
Work-Life Balance: Inspired to perform well by having ample time to pursue work and interests outside of work
Self-Starter: Inspired to perform without outside help
Job Security: Inspired to perform well by the knowledge that your job is safe

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