Specialty Pharmacy Biller
Location
Altamonte Springs, FL | United States
Job description
About the Company:
Our client is committed to delivering an elevated healthcare experience with a focus on whole health. The company combines clinical expertise, digital capabilities, and broad access to specialty medications to provide unparalleled service and support throughout the consumer's treatment journey.
Salary: Job Summary:
The Billing Coordinator requires an individual with expertise in billing and appeals, specifically in Medicare/MediCal. The position involves ensuring accuracy in patient account files, maximizing reimbursement, and handling appeals. Two shifts are available: Monday-Friday, 10am-7pm or 11am-8pm.
Job Responsibilities:
- Review patient account files for accuracy and completeness.
- Prepare and review billings for submission to primary/secondary insurance carriers and/or Medicare/MediCal.
- Manage and maintain third-party accounts.
- Respond to patient, insurance carrier, and internal and external inquiries.
- Complete daily denial and correspondence tasks.
- Submit refund requests to insurance carriers.
- Re-bill claims when not paid properly.
- Check billing to ensure correctness, comparing prescriptions to claims, running claims, secondary claims, co-pay cards, and handling rejections.
- Work onsite following one of two schedules: Monday-Friday, 10am-7pm or 11am-8pm.
Qualifications:
- High School diploma required.
- Minimum of 2 years of experience in billing and appeals process in Medicare/MediCal, including medical office experience, or equivalent education and experience.
- Preferred skills: ICD-9 and CPT-4 coding knowledge, Electronic specialty pharmacy billing experience.
- Required skills: Experience with Medicare Part B
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