Billing Specialist

Reliance Rx Specialty Pharmacy Management, LLC; Buffalo (NY); Ibrido; USD 31.000 - 32.000; Tempo pieno

Vantaggi offerti da questo lavoro

Shift differential

Health benefits

Paid time off

Incentive program

Descrizione del lavoro

Reliance Rx Specialty Pharmacy Management, LLC is hiring a Billing Specialist to handle billing of pharmacy and medical claims, manage rejections, and liaise with patients, insurers, and providers. The role is hybrid (onsite Williamsville) with training then a schedule including shifts and a possible evening differential.

Requirements include a high school diploma or GED, 1 year of high-volume pharmacy experience or 6 months in related dept, and preferred CPhT certification.

Competenze

• High school diploma or GED required; CPhT preferred.
• 1 year of high-volume pharmacy experience, or 6 months in related dept.
• Experience with online claims processing systems preferred.
• Clear oral and written communication skills for healthcare coordination.
• Ability to lift a minimum of 5 lbs.
• Demonstrates Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive.

Mansioni

• Billing all pharmacy and medical claims and managing rejections.
• Liaise between patients, insurers, doctors, and staff.
• Resolve billing issues with payors and ensure CMS guidelines compliance.
• Confirm billing accuracy and payor requirements.
• Process deliveries to medical offices and manage medical/pharmacy claims.
• Verify financial aspects before claims exit the facility.
• Portal management: refill reminders, orders, and patient registrations.
• Coordinate financial assistance for patients where applicable.
• Support Patient Care Specialists with calls and documentation.

Conoscenze

Communication skills

Aptitude for healthcare team

Ability to lift 5 lbs

Formazione

High school diploma or GED

National Pharmacy Technician Certification (CPhT) preferred

Strumenti

Online claims processing system

Descrizione del lavoro

FIND YOUR FUTURE

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

Overview

The Billing Specialist assists with the various activities of the pharmacy operations not requiring the professional judgment of the pharmacist. The Billing Specialist is primarily responsible for completing the billing of both pharmacy and medical claims and adjudicating rejections.

This position will be hybrid 3 days onsite and 2 days remote after three months of onsite training (M-F 8:30am-5pm). After training, scheduling includes one opening shift, two mid-shifts and two closing shift per week. Associates who work evening hours after 6pm are eligible for a shift differential.

Qualifications

• High school diploma or GED required. National Pharmacy Technician Certification (CPhT) preferred.
• One (1) year of experience working in a high-volume pharmacy, or equivalent setting, required, or six (6) months as a temporary associate in the Reliance Rx Operations & Compliance department.
• Experience working with online claims processing system preferred.
• Effective oral and written communication skills and an aptitude for working with other health care professionals.
• Ability to lift a minimum of 5 lbs.
• Proven examples of displaying the Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive.

Essential Accountabilities

• Responsible for billing all claims (pharmacy and medical) and managing rejections to ensure appropriate follow up and delivery promise times are met.
• Act as a liaison between patients and insurance companies, and facilitate communication between patients and doctors, medical staff and administrative staff.
• Work with payors to resolve any billing issues.
• Ensure Reliance Rx is following CMS guidelines per Medicare and Medicaid guidance
• Confirmation of billing accuracy and payor billing/shipping requirements.
• Process and set up deliveries to medical offices.
• Medical claims billing for both supplies and medications.
• Confirm financial aspects of the claims prior to them leaving the facility.
• Portal management including refill reminders, processing orders from the portal, and completing patient registrations.
• Financial assistance coordination with patients for foundation care, copay assistance, or free medication programs where applicable.
• Assist the Patient Care Specialists in workflow and with incoming and outgoing calls in accordance with business needs, to include but not limited to:

Assist the Patient Care Specialists in workflow and with incoming and outgoing calls in accordance with business needs, to include but not limited to:

• maintaining patient records; filing and documentation duties.
• set up and data entry.
• financial arrangements and collecting co-payments.
• prior authorization assistance with offices.
• coordination of benefits.
• promote information sharing and continuous process improvement.

Function in strict accordance with standard, written procedures and guidelines with deviation approved by the supervising pharmacist.

Hourly / Non-Exempt

This is a hybrid position with onsite attendance required at our Williamsville location.

Immigration or work visa sponsorship will not be provided for this position

Hiring Compensation Range: $22.50 - $23.50 hourly

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Aff ⅖? ... Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub.