Guardian Mid-South Pharmacy is part of the Guardian Pharmacy Services network and prides itself on its customer service. Each team member plays an integral part in the success of the pharmacy.
Under the direction of the Director, Finance & Administration, responsible for making sure all prescriptions are billed properly, accurately, timely, and cost effectively to ensure payment and avoid accounts receivable issues.
- Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
- Leadership – ability to lead project teams to deadlines, while maintaining strong team orientation
- Relational – ability to build relationships with business unit management and become “trusted advisor”
- Strategy and Planning – ability to think ahead, plan and manage time efficiently
- Problem Solving – ability to analyze causes and solve problems at both a strategic and functional level
- Team Oriented – ability to work effectively and collaboratively with all team members
- Assist in the supervision of the billing department including overseeing day-to-day operations, technician workflow and fielding departmental questions; relays issues or concerns to the Supervisor
- Ensure batches are posted in a timely manner and pre-billing reports are completed accurately and timely
- Review billing errors trying to determine process flaws and develop solutions to correct as needed
- Performs QA assessment on all prior authorizations/rejections at least bi-weekly to ensure team has made corrections and necessary attempts to complete PA
- Assist with training of new hires and continuous team training on new processes and procedures
- Develop a SOP for the billing department; keep the SOP current by ensuring updates are made as processes change
- Ensure all updates / policy and procedures are communicated to other departments
- Assist and support supervisor with month end processes when needed
- Properly admit new patients; adequately complete all needed information to ensure proper billing and payment.
- Work with facilities, families, hospice, third party insurances, and doctors to obtain and secure all needed information to properly bill without AR issues, i.e. Prior Authorizations, Customer Agreements, Insurance and Responsible Party billing information, etc.
- Work rejections until all claims are paid to keep AR risk at a minimum while securing claims from take-back.
- Maintain and work with facilities to keep accurate and current patient census information
- Answer all billing related calls and document all pertinent information, to include but not limited to: what, why, who, where, when. As well as adherence to the use of the Call Log for messages.
- Maintain and monitor AR balances resolving any unpaid balances, i.e. working with facilities and families with a positive approach resulting in a positive resolution and payment.
- Work collaboratively with all co-workers including all departments to assist DFA in minimizing billing issues, customer service issues, AR issues, improve efficiencies and lower costs, which all result in an increase in overall profitability and customer service.
- Analyze Veridikal reports to maximize revenue, margin, and improve clean claims results; as well as monitor and resolve any issues with Claims Reports, High Dollar, AWP/NDC reports, etc.
- As projects, additional responsibilities, or otherwise assigned tasks from the DFA arise, assist in the maintenance and completion of such tasks timely, accurately, and efficiently, i.e. Accpac and Framework activities, Ordering of Supplies, Processing Credits, FWA/HIPPA record keeping, Daily Deposits, Audits, etc.
- Other essential functions and duties may be assigned as needed
Education: High school diploma or G.E.D.
- 5 -8 years’ experience in billing function, preferably in pharmacy-related business
- Excellent computer skills, including pharmacy operating system and billing system
- Pro-active problem-solving skills
- Excellent verbal and written communication skills
- Excellent interpersonal skills and ability to deal pleasantly with customers
- Ability to work independently and deliver to deadlines
- Ability to solve problems with minimal direction
- Great attention to detail and accuracy
- Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines
- Quality minded; motivated to seek out errors and inquire when something appears inaccurate
Ability to work flexible hours; hours of operation are subject to change based on the needs of the pharmacy
Full-Time employees working 30+ hours per week are eligible to enroll in our comprehensive benefits package, which includes medical, dental, vision, short and long-term disability, life and supplemental life insurance, and PTO.
All employees are eligible to enroll in our company matched 401(k) plan.