Pharmacy Billing Specialist

Job Description

Job Description

We are seeking a motivated and detail-oriented Pharmacy Billing Specialist to join our team! The ideal candidate will have a strong background in medical billing, excellent organizational skills, and a commitment to providing superior support in pharmacy claim handling and insurance billing. Must be local to Indianapolis.

Hours : Monday - Friday 8am - 5pm

Responsibilities for the position include the following :

• Provide assistance in preparing and submitting pharmacy claims to third-party insurance carriers as needed.
• Secure and verify all necessary medical documentation required by third-party insurance carriers for claims processing.
• Conduct follow-ups with third-party insurance carriers and patients to address unpaid claims or balances and resolve discrepancies.
• Research and analyze payer regulations and claim guidelines, ensuring compliant billing practices by leveraging payer-specific tools and resources.
• Verify insurance coverage for pharmacy services prior to rendering services, when applicable.
• Re-validate benefit coverage criteria during claim follow-up processes.
• Maintain accurate and thorough documentation of all steps taken to resolve claim-related issues within billing software systems.
• Regularly report claim trends and issues to the Team Lead and / or Billing Manager.
• Collaborate with the Team Lead and / or Billing Manager to establish and achieve short-term and long-term goals while providing progress updates.
• Relevant experience in pharmacy or medical billing.
• Strong understanding of insurance payer guidelines and regulations.
• Proficiency in using billing software and associated tools.
• Excellent communication and problem-solving skills.
• Attention to detail and ability to multi-task efficiently.
• High School Diploma or equivalent
• 3 years related experience
• Software : Athena - EMR; ScriptMed