Billing Specialist

Billing Specialist

Position Summary

The Billing Specialist is responsible for ensuring that all client profiles and customer profiles are accurately and efficiently entered through the appropriate software system as delegated by the Lead Billing Specialist or the Billing Services Manager. The Billing Specialist will work in all functions of the billing services department based on the needs of workflow for that day as delegated by the Lead Billing Specialist or Billing Services Manager. The Billing Specialist will utilize computer hardware and software associated with In Touch Pharmaceuticals property, and any other tools needed to successfully complete their assigned tasks. The Billing Specialist will work as a part of a team to ensure that all the needs of the client and customer are met.

Job Responsibilities and Requirements

The primary purpose of the Billing Specialist is the contribution to a team effort to complete billing functions on all client and customer profiles ensuring accuracy and efficiency to meet a predetermined deadline for processing. Routinely applies critical thinking skills and effectively initiates resolution to problems identified by the customer. The Billing Specialist may be required to sit for long periods of time, frequent movements of fingers and hands, and ability to maintain professionalism while handling outgoing and incoming calls from customers.

Essential Functions

The essential functions of the Billing Specialist position include: the adjudicating of all pharmacy prescription claims from updated client and customer profiles, assurance that all necessary documentation for billing practices (i.e. consent form and responsible party form) is received and completed.

Customer Service

o Routinely applies telephone etiquette with peers and customers. Greeting, tone of communication and problem-solving concerns are professional.

Client and Customer Profiles

o Routinely updates client and customer profiles ensuring accuracy to billing information, A/R profile, to appropriately adjudicate claims

o Upon updates, completes profile review to ensure that claims are paid.

Pre-Billing

o Prioritizes predetermination of billing claims to ensure that all medications are paid prior to completed statement release.

o Understands separation of facility payment and private payment when pre-billing.

Use of Company Resources Appropriately

o Pharmacy electronic software systems and tools

Compliance with Company policy and procedures

o Attendance at Department meetings

o Compliance with company handbook regulations (i.e. dress code, recording your time, conduct of behavior, etc.)

o Wears ID badge and enters time clock information as required.

o Personnel Payroll System

Compliance with Company Communication Practices

o Company electronic communication system(s)

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