Billing Specialist

VIVA USA Inc; Monroeville (Allegheny County); Hybrid; USD 42,000 - 54,000; Full time

Job summary

VIVA USA Inc. is seeking a Billing Specialist I to qualify, prepare, and submit claims to Medicare Part B, Major Medical and Medicaid. The role requires collaboration with LTC staff, prescribers, payers and patients to drive accurate billing and timely resolutions.

This position supports hybrid work arrangements with potential time at home based on performance and business need. A strong emphasis is placed on accuracy, customer service, and adherence to payer requirements.

Qualifications

• 0-2 years of pharmacy billing or healthcare reimbursement experience.
• Strong communication and organizational skills.
• Proficient in Microsoft Word, Excel and Outlook.
• Ability to work in a fast-paced environment and prioritize tasks.
• Knowledge of medical terminology and payer requirements.

Responsibilities

• Qualify, prepare and submit claims to Medicare Part B, Major Medical and Medicaid.
• Work with LTC staff, prescribers, third party payers and patients to resolve claims.
• Use multiple systems to retrieve documents and gather supporting information.
• Ensure timely and accurate billing for unbilled claims and outstanding balances.
• Maintain compliant billing practices and provide excellent customer service.

Skills

Healthcare billing

Reimbursement systems

Task prioritization

Medical terminology

Customer service

MS Word/Excel/Outlook

Education

High School diploma or GED

Tools

MS Word

Excel

Outlook

Job description

Work location may be hybrid with the potential to have some time at home based on performance and business need.

Position Summary

Billing Specialist I will be responsible for qualifying, preparing and submitting claims to Medicare Part B, Major Medical and Medicaid. Individual must work with LTC facility staff, clientpharmacy operations staff, prescriber offices, third party payers, patients and/or their responsible parties and claim processors. This position requires work within several different operating systems and web based programs to retrieve document images, collect supporting or additional information on fills and work claims through to resolution to ensure compliant, timely and accurate billing practices.

The Pharmacy Billing Representative will ensure timely and accurate billing for unbilled claims and ensure account payment for outstanding balances while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. This position requires work within several different operating systems and web based programs to retrieve document images, collect supporting or additional information on fills and work claims through to resolution to ensure compliant, timely and accurate billing practices.

Duties

• Minimum 1 year experience performing healthcare reimbursement, medical insurance/billing or related work.
• Minimum 1 year experience working with healthcare reimbursement systems.
• Ability to prioritize daily tasks.
• Working knowledge of medical terminology.
• Customer service skills with the ability to work in a team environment.
• Experience in MS Word, Excel and Outlook.

Experience

Minimum (Required) Qualifications: (must be met in order to perform the job at the required level) Entry level position; 0-2 years of pharmacy billing experience Strong communication, interpersonal, and prioritization skills Must be highly organized and detail-oriented. Ability to work in a fast paced, rapidly changing environment Good computer skills requiring basic knowledge of Microsoft Word, Excel, PowerPoint, Outlook and good typing skills.

Education

Verifiable High School diploma or GED is required.

Notes:

Monday-Friday 8am to 4:30pm

Hybrid - Work location may be hybrid with the potential to have some time at home based on performance and business need.

VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status