Remote Pharmacy Billing Operations Specialist – RareDisease

PANTHERx Rare Pharmacy; Pittsburgh (Allegheny County); Hybrid; USD 52,000 - 74,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K with employer matching

Paid time off

Paid holidays

Flexible working arrangements

Job summary

PANTHERx Rare Pharmacy in Pittsburgh, PA is seeking a Billing Operations Specialist to bill and collect from payer accounts, coordinating with PBMs and payers to determine billing guidelines and ensure timely payments. You will bill NCPDP claims, make collection calls on past-due accounts, research rejections, and process refunds while tracking denials and reconciling member accounts.

This role offers a professional office environment with hybrid/remote options and a comprehensive benefits

Qualifications

• Bachelor’s degree in business or related field; equivalent work experience may substitute.
• Detailed understanding of Pharmacy billing/collections practices with all payer types.
• Excellent oral and written communication skills communicating effectively with all levels of management.
• Strong problem-solving skills to evaluate all aspects of a problem or opportunity and draw valid conclusions to make appropriate and timely decisions.
• Consistently uses tact, sensitivity, sound judgement, and a professional attitude.
• Knowledge of Microsoft Office Suite, especially Excel, Outlook, and PowerPoint.

Responsibilities

• Bills specialty pharmacy NCPDP (National Council for Prescription Drug Programs) claims.
• Makes collection calls and research on past due assigned accounts.
• Communicates with PBM for various rejections or overrides.
• Researches and processes refunds as required.
• Tracks denials trending.
• Prepares Bad Debt Write-Offs as required.
• Reconciles member accounts as needed.
• Handles multiple tasks and meets deadlines.
• Other duties as assigned within scope of practice.

Skills

Billing/collections knowledge

Communication skills

Problem-solving

Professional attitude

Microsoft Office Suite (Excel, Outlook

Education

Bachelor’s degree in business or related field

Tools

Microsoft Excel

Outlook

PowerPoint

Job description

PANTHERx Rare Pharmacy in Pittsburgh, PA is seeking a Billing Operations Specialist to bill and collect from payer accounts, coordinating with PBMs and payers to determine billing guidelines and ensure timely payments. You will bill NCPDP claims, make collection calls on past-due accounts, research rejections, and process refunds while tracking denials and reconciling member accounts.

This role offers a professional office environment with hybrid/remote options and a comprehensive benefits