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Revenue Cycle Specialist - Pharmacy Buy and Bill
7 days agoWhat's your preference?
Job Description
- Req#: 9681
Employer Industry: Healthcare Revenue Cycle Management
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work in a supportive and collaborative environment
- Engage in meaningful work that contributes to efficient healthcare delivery
- Competitive salary based on experience
- Chance to optimize processes and reduce billing denials
What to Expect (Job Responsibilities):
- Submit accurate claims for buy-and-bill medications to insurance payers
- Track claims to ensure timely processing and reimbursement
- Reconcile payments and outstanding balances for buy-and-bill medications
- Confirm insurance eligibility and coverage for buy-and-bill medications
- Identify opportunities to optimize the buy-and-bill billing process
What is Required (Qualifications):
- Minimum educational requirement: High School Diploma or equivalent
- Minimum of 2 years of experience in medical billing, pharmacy billing, or revenue cycle management, particularly in buy-and-bill processes
- Advanced knowledge of medical terminology, ICD 10, CPT, HCPCS coding, and HIPAA requirements
- Demonstrated proficiency in the use of computer and commonly used software, including electronic medical records (EMR)
- Extensive knowledge and experience with commercial, government, and state billing and reimbursement procedures
How to Stand Out (Preferred Qualifications):
- Experience in insurance verification, prior authorization, and accounts receivable follow-up
- Strong attention to detail and organizational skills
- Customer service orientation and analytical thinking
- Proven ability to communicate effectively, both orally and in writing
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