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Pharmacy Medical Billing Specialist

Company: Albertsons Companies
Location: Boise
Posted on: May 19, 2019

Job Description:

Job Title Medical Billing Specialist Reports To VP of Patient Care, Specialty and Wellness Services PURPOSE: Responsible for the timely submission and follow up of medical claims to insurance companies to ensure timely receipt of payment. Improving quality, processes and procedures to maximize reimbursement. KEY ACCOUNTABILITIES: Key Accountability Approximate % of time

  • Verify patient benefit, complete prior authorization requirements, ensure all claims are submitted accurately with a goal of zero errors. Make necessary arrangements for completion of additional information requests as requested by insurance companies-30%
  • Resolve reimbursement issues or billing obstacles. consistently follow up on unpaid claims utilizing monthly aging reports and filing appeals when appropriate to obtain maximum reimbursement. Work closely with accounting department to assure payments are applied correctly and utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days-30%
  • Respond to inquiries from insurance companies, patients and providers. Maintain a working knowledge of guidelines and criteria for specialty medications set by third party payers. Identify medical plans that require contracting and work closely with managed care department to get contracts in-place. 20%
  • Assist with the implementation of a new billing system, plan and implement quality improvement, update procedures to streamline billing and collections processes.-20% Job Requirements Relevant Experience, Education, Certification, Knowledge, Skills and Abilities Required
    • Computer experience is essential, including, but not limited to: practice management software, word processing and spreadsheet applications.
    • Training and experience in HCPCS, J-code, CPT and ICD coding; familiarity with medical terminology.
    • Track record for improving process efficiencies and solving problems.
    • Strong written and verbal communication skills.
    • Ability to manage relationships with various Insurance payers.
    • Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
    • Perform to company standards of compliance with policies and procedures.
    • Ability to multi-task and work courteously and respectfully with fellow employees, clients and patients.
    • Attention to detail and quality focused.
    • Professionalism and strong work ethic. Preferred
      • Specialty medication medical billing experience Physical Environment
        • Some travel may be required.
        • Most work is performed in a temperature-controlled office environment.
        • Incumbent may sit for long periods of time at desk or computer terminal.
        • Incumbent may use calculators, keyboards, telephone, and other office equipment in the course of normal workday.
        • Stooping, bending, twisting, and reaching may be required in completion of job duties. The above statements are intended to describe the general nature of the work performed by the employees assigned to this job. All employees must comply with Company policy and applicable laws. The responsibilities, duties and skills required of personnel so classified may vary within each department and/or location. EOE

Keywords: Albertsons Companies, Boise , Pharmacy Medical Billing Specialist, Accounting, Auditing , Boise, Idaho

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