Pharmacy Billing Coordinator II
University of Maryland Medical System
Job Requirements Job Summary The Pharmacy Billing Coordinator I inputs and reviews billing information; prepares reports, tables, graphs and interprets results; and researches and reconciles billing problems in accordance with policy, procedure, and regulations; works with the health care team to ensure that patients can obtain authorization for treatments by utilizing and interpreting clinical information to complete authorizations and patient assistance program enrollments; completes complex insurance reconciliations when needed; manages and completes audits and payor requests ensuring that specialty patients have the necessary financial coverage and authorizations for both pharmacy and medical infusion treatments to begin, maintain, and complete treatment. Specific responsibilities will be documented and retained internally by the Department of Pharmacy. Primary Responsibilities The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job responsibilities performed.
• Some college.
• National Certification (CPhT).
- Works to maximize optimum pharmacy revenue through pharmacy authorizations, appeals, and pharmacy claim reconciliation via customer and insurance payments.
- Communicates with insurance companies and health care providers and teams to ensure that patients have access to medications through optimizing insurances payments, coordination of benefits, copay assistance, financial and patient assistance programs.
- Investigates and addresses insurance issues including but not limited to billing issues and/or pharmacy authorizations on behalf of providers.
- Extensive knowledge of medical and pharmacy (including Medicare and specialty billing).
- Perform all other duties as assigned.
- High School Graduate or equivalent.
- 5 years of experience.
- Pharmacy Leadership and/or specialty pharmacy and/or billing experience.
- Maryland Technician Registration OR Medical Assistant License.
• Some college.
• National Certification (CPhT).
Vacancy posted 16 days ago
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