Pharmacy Billing Specialist

Job Description

Job Description

Location- Sacramento, CA

Hours- M-F 9am- 5:30pm

Pay- $24/28/hr

POSITION SUMMARY

The Billing Specialist is responsible for completing all billing tasks required to complete the billing cycle accurately and on time. This role works with insurance providers, nursing center staff, and prescribers’ offices to ensure proper claims submission and resolution. The Billing Specialist provides support and feedback regarding billing errors to pharmacy personnel. Prior medical or pharmacy billing experience is preferred.

ESSENTIAL FUNCTIONS AND ACCOUNTABILITIES

• Runs and reviews daily and monthly billing logs; corrects coding errors and discrepancies.
• Posts monthly charges, credits, and adjustments to patient and facility accounts.
• Processes account changes as they occur (address, billing status, insurance information, etc.).
• Runs monthly accounts receivable statements and prepares them for mailing.
• Completes billing on or before deadlines as specified by the President/Vice President and/or facility.
• Processes incoming and outgoing correspondence related to billing as needed.
• Completes required collection letter forms for past-due accounts.
• Tracks collection letter dates and documents responses and pertinent account information.
• Submits bad debt accounts to the Billing Supervisor after all reasonable collection attempts have been exhausted.
• Performs prescription claims adjudications for all pharmacy insurance programs.
• Handles Medicare Part A (Med-A) billing to nursing facilities.
• Manages billing rejections and resolves issues in a timely manner.
• Manages refill-too-soon rejections process.
• Assists with prescription billing errors.
• Manages prior authorization prescription orders.
• Inputs new patient profiles accurately into the billing system.
• Other duties as assigned by the Billing Supervisor, Accounting Manager, President, Vice President, or a Manager.

Job Requirements

MINIMUM QUALIFICATIONS-

Education & Experience

• High School Diploma or GED required.
• At least one year of pharmacy billing experience preferred.
• Must be capable of maintaining regular attendance and working with minimal supervision.

KNOWLEDGE, SKILLS, AND ABILITIES

• Proficiency in Windows-based software including word processing and spreadsheet applications; MS Excel preferred.
• Excellent phone and customer service skills.
• Strong organizational skills; ability to prioritize and manage multiple tasks.
• Ability to adhere to regulatory and company compliance requirements (OSHA, DEA, State Board of Pharmacy, etc.).
• Knowledge of current state, federal, and company billing policies, procedures, and regulations.
• Understanding of residents’ rights regulations applicable to long-term care facilities.

PROFESSIONAL STANDARDS AND CONDUCT

• Maintains a friendly, professional, and customer-focused demeanor at all times.
• Exhibits a professional service attitude, willing to go above and beyond to accommodate the needs of our facilities and patients.
• Flexible and adaptable in response to changing company and facility needs.
• Maintains professionalism and communicates through appropriate channels.
• Demonstrates enthusiasm and initiative for the position and for the company’s mission.
• Treats fellow employees with consideration, patience, and respect.
• Maintains a positive self-image and earns the respect of colleagues through consistent, reliable performance.
• Remains composed and works effectively under pressure during peak operational periods.

PHYSICAL REQUIREMENTS AND WORK ENVIRONMENT

Office environment with extensive computer terminal use. Reasonable accommodations will be provided per FEHA and ADA.

• Regularly required to sit for extended periods, use a keyboard and telephone, and communicate in writing and verbally.
• Equipment used includes: telephone, 10-key, fax machine, copier, and computer.

About Capital Staffing Inc:

Established in 2011, Capital Staffing, Inc is a full service SBE staffing firm, committed to providing a high level of support to all of our employees. We appreciate your choice in partnering with us for your future employment!

Capital Staffing, Inc employs a wide range of highly skilled administrative/customer service, accounting/finance, industrial, healthcare, scientific, manufacturing and IT professionals across various industries.

Capital Staffing, Inc provides contract, contract to hire, and direct placement recruiting services.

We are proud to serve you and our local community!