• Billing Specialist

    Job ID
    2019-3964
    Department
    Billing/Collections
  • Overview

    Billing Specialist

    West Allis, WI

     

    Prescriptions Plus 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 the Business Manager, process claims to insurance companies and perform all billing related processes and providing excellent customer service and care to patients, caregivers, and medical providers.

     

    Attributes:

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

     

    Responsibilities:

    • Reviews Patient files to verify refill status
    • Bills cycle billings through dispensing system to insurance companies
    • Verifies billing
    • Contacts Beneficiaries/Caregivers regarding outstanding balances.
    • Establishes payment plans to help Beneficiaries manage payment of bills.
    • Sends delinquent accounts to collection agencies.
    • Processes insurance payments to Beneficiary accounts in computerized system.
    • Creates and mails insurance claims and Beneficiary statements.
    • Rebills insurance companies or other third parties to secure payment for Beneficiaries.
    • Trains appropriate personnel on computerized billing system.
    • Responds to Beneficiary billing and statement inquiries.
    • Makes recommendations to management for write-offs.
    • Other essential functions and duties may be assigned as needed

     

    Education: High School Diploma or G.E.D.

     

    Requirements:

    • 1+ years of related experience (advanced degree may substitute for experience)
    • 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
    • Long term care or retail pharmacy technician or billing experience preferred, but not required

     

    Work Environment:

    Must occasionally lift up to 40 pounds

    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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