Nationally Certified Pharmacy Billing Specialist

Job Description:

The Pharmacy Billing Specialist is responsible for collecting posting and managing patient account payments. The position is responsible for submitting patient claims to insurance companies and following up on claims with insurance companies.

Supervisory Responsibilities: 

• This position has no direct supervisory responsibilities. 

Essential Duties and Responsibilities: 

• Preparing and submitting clean claims to various insurance companies either electronically or by paper
• Answering questions from patients clerical staff and insurance companies
• Identifying and resolving patient billing complaints
• Preparing reviewing and sending patient statements
• Evaluating patient’s financial status and establishing budget payment plans; following and reporting the status of delinquent accounts
• Reviewing accounts for possible assignments and making recommendations to the Billing Supervisor
• Prepares information for the collection agency
• Performing various collection actions including contacting patients by phone; correcting and resubmitting claims to third-party payers
• Participating in educational activities and attending monthly staff meetings
• Maintaining the strictest confidentiality; adhering to all HIPAA guidelines and regulations

Skills/Abilities: 

• Detail-oriented and accurate
• Ability to operate a computer computer software and basic office equipment
• Ability to operate a multi-line telephone system
• Skilled in answering a telephone in a pleasant and helpful manner
• Ability to read understand and follow oral and written instructions
• Ability to establish and maintain effective working relationship with patients associates and the public
• Proficiency in reading writing and speaking English in required

Education and Experience:  

• 1 year of medical billing and collections practice experience preferred
• Knowledge of basic medical coding and third-party operating procedures and practices preferred
• Knowledge of business office procedures

Certificates/Licenses/Registration:

• Pharmacy Technician Certification (PTCB) license required for all new hires.
• Existing associates required to obtain the Pharmacy Technician Certification (PTCB) license by 8/1/2025.
• Must be a fully licensed technician in the State of Indiana or willing to earn license upon employment

Physical Requirements: 

• Work is performed indoors with potential for exposure to safety and health hazards related to office work. Could periodically travel to other office and operational sites.  The noise level in the work environment is usually moderate.
• Prolonged periods of sitting at a desk and working on a computer.