What are the responsibilities and job description for the Pharmacy Customer Service/Billing Representative position at UHS Pruitt Corp?
Billing, Collections and Posting Professional
Pruitt Health Home Infusion pharmacy is looking for an experienced and motivated Billing, Collections and Posting Professional to join our dynamic team! The billing and collection professional is responsible for a broad range of billing processes related to managing the Ready to Bill bucket (unbilled revenue). The Billing professional will proactively work with assigned payers billing to maximize accurate and timely payment. Responsible for contract analysis, reimbursement, denial management, appeals and resolving billing-related issues with insurance companies or other responsible parties for services rendered.
Billing
Manages the "Ready to Bill" queue daily; performs QA to insure accurate and timely creation of new claims and insures submitted claims meet payer guidelines; generates invoices ensuring they are accurate and reflect the products or services provided, tracks outstanding invoices. Processes confirmed tickets in "unworked" status within 48 hours of confirmation date; assigns an appropriate status to ensure proper handling by branch and billing personnel; makes necessary demographic changes to reduce rejections of submitted electronic and paper claims. Works "resolved" unbilled tickets within 24 hours to "ready" or next status for resolution. If applicable, submit secondary billing in a timely manner with appropriate supporting documentation per payer-specific guidelines to ensure expected revenue is allowed. Research websites of assigned payers to bill for payer updates and share updates accordingly with staff.
Collections
Strong skills and knowledge in home infusion pharmacy collections and timely follow ups with insurance companies and contacting customers to collect payments, setting up repayment plans, and advising customers of default consequences. Ensures daily accomplishments work towards company goals for cash collections and A/R over 90 days, Ready to Bill under 14 days, weekly and month-end close processes, and other departmental goals as outlined.
Posting
Posting payments to accounts and reconciling the accounts as approved
Account maintenance
Maintaining files on the financial status of accounts through billing notes and alerts, updating / recording address changes, renewing PA's and deactivating old accounts as needed
Reporting
Reporting financial data, maintaining balance sheet schedules, and processing month end journal entries
Other responsibilities may include: Identifying issues that may lead to account delinquency, Resolving customer account inquiries, High-volume processing, Recalculating, and Reconciliations.
Other Duties and Responsibilities:
Works within specified deadlines and stressful situations.
Works overtime when necessary to meet department goals and objectives.
Performs other tasks or special projects as assigned.
Interpersonal skills, Attention to detail, Ability to maintain knowledge of third-party payment application requirements and regulatory guidelines, Strong written and verbal communication skills, and Strong analytical skills.
Education/Experience:
High School Diploma or equivalent (GED) required.
Bachelors Degree or equivalent required.
Excellent interpersonal, communication and organizational skills required.
Ability to prioritize, problem solve, and multitask is required.
A minimum of 3 years of experience in Home Infusion Pharmacy billing and collections, with a working knowledge of managed care, commercial insurance, and Medicare reimbursement preferred
Job Type: Full-time
Pay: $20.00 - $22.00 per hour
Expected hours: 40 per week
Benefits:
Benefits Election (TBA)
Schedule:
Day Shift 8 hours (8:30am - 5:00)
Work setting:
Office (This is not a remote position)
Experience:
*3yrs Home Infusion Pharmacy Billing, Collections & Posting Experience (Required)
*2yrs Bright Tree Software Experience (Required)
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We are eager to connect with you! Apply Now to get started at PruittHealth!
As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.
Salary : $20 - $22
