MED D BILLING REPRESENTATIVE

PharMerica

Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!

We offer:

DailyPay

Flexible schedules

Competitive pay

Shift differential

Health, dental, vision and life insurance benefits

Company paid STD and LTD

Tuition Assistance

Employee Discount Program

401k

Paid-time off

Tuition reimbursement

Non-retail/Closed-door environment

Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!

Acts as a resource to the facilities in obtaining information, completing necessary documentation, and following up on outstanding claims.
• Understands Insurance and Medicaid formularies and processes, including the prior authorization processes.
• Makes outgoing calls to Facilities, Plans, and Physician's offices as needed to obtain approvals
• Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to effectively communicate and resolve customer issues.
• Provides clinical support to members of the RxAllow team regarding prior authorization concerns
• Achieves productivity goals with regard to calls/claims per hour, as determined by the Director and Clinical Hub Manager.
• Prioritizes work to meet daily and competing deadlines.
• Develops a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow.
• Maintains a clean and organized work area.
• Performs other tasks as assigned.

Education/Learning Experience:

• Required: HS Diploma or equivalent experience.
• Desired: Associate degree/ Bachelor's Degree.

Work Experience:

• Required: Third Party Medical Billing Experience.
• Desired: 1-3 years pharmacy experience; 3 years call center experience.

Skills/Knowledge:

• Required: Familiar with the claim adjudication process. Proficiency in Microsoft Office.
• Desired: Understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow.

Licenses/Certifications:

• Required: Certified Pharmacy Technician.

Behavior Competencies:

• Required: Interpersonal Skills, Oral Communication, Written Communication, Teamwork, Ethics, Organizational Support, Judgment, Planning/Organizing, Professionalism, Adaptability, Initiative.