• Billing Specialist

    Job ID
    2018-3323
    Department
    Billing/Collections
  • Overview

    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.

     

    Job Objective:

    Under the direction of 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.

     

    Attributes:

    • Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
    • 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

     

    Responsibilities:

    • 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 with the Billing Team to effectively execute closing and production of monthly billing.
    • 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.
    • Play an active role in onboarding and training of new or retraining of existing staff.
    • As projects, additional responsibilities, or otherwise assigned tasks from the DFA arise the administrative department will assist in the maintenance and completion of such tasks timely, accurately, and efficiently, i.e. Accpac and QS1 activities, Ordering of Supplies, Processing Credits, FWA/HIPPA record keeping, Daily Deposits, Audits etc. 
    • Work as a Pharmacy Technician in other functional areas when needed and appropriate.
    • Perform other duties and projects as assigned
    • Maintain CPht
    • Attendance and punctuality consistently compliant
    • Adherence to company policies
    • Professional, pleasant, and effective phone etiquette exhibiting excellent customer service skills
    • Embraces constructive feedback on quality indicators, professional development, and process improvements
    • Other essential functions and duties may be assigned as needed

     

     

    Education: High school diploma or G.E.D.

     

    Requirements:

    • CPhT preferred
    • 1+ years of billing experience, preferably in pharmacy related business
    • [Advanced computer skills; pharmacy operations system experience preferred/required]
    • 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

      

    Work Environment:

    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.

     

     

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