Required Education:

• Verifiable High School Diploma or EquivalentRequired Qualifications/Skills/Experience:

• Minimum 1 year of experience performing healthcare reimbursement, medical insurance/billing, or related work
• Minimum 1 year of experience working with healthcare reimbursement systems
• Working knowledge of medical terminology
• Experience with Microsoft Word, Excel, and Outlook
• Strong communication and interpersonal skills
• Strong customer service skills and ability to work effectively in a team environment
• Strong organizational and prioritization skills
• Ability to prioritize daily tasks
• Ability to work in a fast-paced, rapidly changing environment
• Good computer and typing skills
• Ability to work across multiple operating systems and web-based programs

Preferred Qualifications/Skills/Experience:

• 1-2 years of pharmacy billing experience
• Experience qualifying, preparing, and submitting claims to Medicare Part B, Major Medical, and Medicaid
• Experience working with pharmacy operations, LTC facilities, prescriber offices, third-party payers, patients, or claim processors

Pharmacy Billing Representative Overview:

• The Pharmacy Billing Representative is responsible for supporting timely and accurate billing activities, including qualifying, preparing, and submitting claims and working outstanding balances through resolution
• The role requires experience with healthcare reimbursement, medical insurance or billing, and healthcare reimbursement systems
• The representative will work within multiple operating systems and web-based programs to retrieve document images, collect supporting information related to fills, and process claims through resolution while maintaining compliant, timely, and accurate billing practices
• The position also involves communication with healthcare facility staff, pharmacy operations teams, prescriber offices, third-party payers, patients, responsible parties, and claim processors
• Strong organization, prioritization, customer service, communication, computer, and Microsoft Office skills are important for success
• This is a hybrid opportunity based in the Monroeville, Pennsylvania area, with potential to work from home based on performance and business needs

Job Duties:

• Qualify, prepare, and submit claims to Medicare Part B, Major Medical, and Medicaid
• Process unbilled claims and support timely account payment for outstanding balances
• Work within multiple operating systems and web-based programs
• Retrieve document images and collect supporting or additional information on fills
• Research and work claims through resolution
• Maintain compliant, timely, and accurate billing practices
• Communicate with LTC facility staff, pharmacy operations staff, prescriber offices, third-party payers, patients, responsible parties, and claim processors
• Prioritize daily billing activities and manage multiple tasks
• Provide excellent customer service and work effectively within a team environment
• Use Microsoft Word, Excel, and Outlook as part of daily workflow
• Only those lawfully authorized to work in the designated country associated with the position will be considered.
• Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.