Overview:
We are seeking a detail-oriented Pharmacy Billing Specialist to join our team. The ideal candidate will have a strong background in pharmacy billing and coding, possess knowledge of pharmacy terminology, and be familiar with various pharmacy billing systems.
Responsibilities:
- Review and screen new patients at Intake to determine if the patient has adequate prescription coverage.
- Identify patients who may qualify for medication assistance programs or copay assistance.
- Submit prior authorization requests and follow up on the submitted request to obtain approval or determination of preferred provider if not approved.
- Make calls to Payers to troubleshoot and resolve rejections in the claims’ submission process, including maximum allowable and vacation overrides.
- Meet all timely filing requirements related to claims submission.
- Communicate Payer specific data for the management of claims in other departments.
Qualifications:
- Experience in pharmacy collection and billing processes.
- Familiarity with various pharmacy billing systems.
- Able to use a computer and other equipment associated with a general office environment.
- Strong attention to detail and accuracy in data entry.
- Ability to work efficiently in a fast-paced environment.
- Excellent communication and interpersonal skills.
This position offers an opportunity to work in a dynamic healthcare setting! With over 25 years in business, we are a specialty pharmacy dedicated to serving patients with hemophilia through our partnerships with Hemophilia Treatment Center clients throughout the United States. Our team manages over $13M in hemophilia claims monthly, achieving a collection rate of 99.95%. Join us in providing exceptional service to our patients and partners by utilizing your expertise in pharmacy billing while contributing to the financial health of the organization.
Job Type: Full-time
Pay: $22.00 - $25.00 per hour
Expected hours: 80 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Holidays
- Monday to Friday
Work setting:
Experience:
- ICD-10: 1 year (Preferred)
- Pharmacy Billing: 1 year (Preferred)
Ability to Commute:
- Irvine, CA 92614 (Required)
Ability to Relocate:
- Irvine, CA 92614: Relocate before starting work (Required)
Work Location: In person