Billing Specialist

Job Title: Billing Specialist

Location: Toledo, OH 43606 (Onsite)

Duration: 03 Months Contract

Shift: 8:00 am - 4:30 pm

Job responsibilities:

• This role is supporting a project. The they get paid by pharmacy payers, these payments go into a centralized profile. The team pulls these payments and populates them into a PDF. The PDF files will be sent to the two hires working in this role and they will enter the payments and confirm the details of the payments. This is a very repetitive position and they should expect to process on average 150-200 line items daily. Any flagged items will be flagged to other members of the team. This role is primarily data entry versus reconciliation (typing in prescription numbers). The job description is for the role but the duties are much less detailed and consist of primarily only line 1 under accountabilities. They are hiring for these roles because of the back log. It's a project to get all of this data caught up so when they switch to a new software in March they don't have any payments missing in the old software.

FACILITY JOB DESCRIPTION:

Position Summary- This position will be responsible for ensuring timely and accurate payment to pharmacy for products and services. Additionally, the position will be responsible for monitoring, resolving, and preventing any issues that lead to non-payment.

Accountabilities:

*All duties listed below are essential unless noted otherwise*

• Cash posting and reconciliation of pharmacy claims via remittance detail, both electronic and manual, utilizing Central Pay and other mechanisms.
• Monitoring and resolution of non-payments and variances in remittance detail to optimize reimbursement.
• Develop and maintain controls, processes, and procedures to ensure prompt and accurate payment of pharmacy claims. Provides feedback to Director for staff education needed to improve billing and/or compliance issues.
• Responsible for maintenance of the Accounts Receivable reports to meet established A/R goals.
• Assist pharmacy staff with medical billing of medications.
• Maintenance of pharmacy charge accounts for patients, cross-charges within ProMedica, and refunds.
• Performs other duties as directed.

Job Requirements:

• At least 2 years of experience working in a data entry position preferably from a healthcare environment but not required.
• Preferred - pharmacy billing experience, but not required
• HS Diploma