Pharmacy Billing Specialist; Amber Specialty Pharmacy

Pharmacy Billing Specialist

At Amber Specialty Pharmacy, our commitment to patient care is unmatched. Enjoy fulfillment in a career where you have the opportunity to make a positive impact on patients with complex and chronic conditions.

Monday-Friday (no weekends)

Hours:

7 am - 6 pm CST; varied shifts (to equal 40 hours per week)

Six paid holidays

Must pass post-offer, pre-employment drug background tests as allowed by state, federal, local ordinance, statutes and licensing/accreditation requirements.

General functions include ensuring accurate insurance information is received and stored, gathering all necessary information to bill electronic NCPDP claims in the appropriate order in the event of multiple payers, reviewing statements to determine accuracy, and navigating financial assistance programs to help patients gain financial support. Communicating with coordinators and co-workers regarding insurance verification and promoting exceptional customer service and professionalism with the community is vital in this position.

The Training Billing Specialist is responsible for boosting the competencies of our employees by developing and conducting effective training documents. Indirectly help enhance the employee's workplace performance with the Company's core values. Will be performing the training needs assessment and learning materials for the billing team.

Reports to:

Lead Pharmacy Billing Specialist

Direct Reports:
None

Primary responsibilities include consulting with patients to resolve all types of payer and coverage issues, contacting the patient, when necessary, to gather insurance and billing information or notify of a delay in processing, conducting a benefits investigation, updating patient accounts, prescriptions, etc., collecting outstanding patient balances, processing adjudication rejections, insurance terminations, and insurance changes, handling patient benefit statement questions to a conclusion, researching and reviewing patient inquiries on account balances, knowing Amber HIPAA policies and maintaining patient confidentiality at all times, working as a team member with all other departments to verify benefits, working knowledge of all necessary computer software to perform job duties, billing claims via electronic NCPDP clearinghouse;

cross-training in Medical billing as time allows, working claims in the clearinghouse to ensure our payers receive them, responsible for aiding in accounts receivable by billing claims correctly and getting them to our payers on time, working with team to achieve Company AR goals, understanding of payer contracts and how claims should be submitted to each payer, having mastered the requirements of a Pharmacy Billing Specialist so they can train new hires on company policies and procedures, including HIPPA policies, gathering and evaluating information from employees and management on previous training to identify strengths, weaknesses, and areas that need improvement, informing employees on scheduled training and tracking their progress, instructing employees to complete a benefits investigation and update patient accounts, prescriptions, etc.,

training new hires and teams on adjudicating rejections, insurance terminations, and insurance changes, educating new hires and the team on how to review statements and patient balances, training new hires and teams on computer software and programs to perform job duties, teaching new hires and team the difference between medical and NCPDP billing, assisting in developing SOP and training documents to perform job duties, monitoring new hires and teams on their progress and ensuring how to perform job duties, assisting the Lead Pharmacy Billing Specialist in training needs;

documenting the employee training.

Professional competencies include proficiency with MS Excel, Word, and Outlook, strong oral, written, organizational and interpersonal skills, ability to work in a team and with all levels of internal management, staff, outside clients, and vendors, demonstrated ability to meet tight deadlines.

Required qualifications include working knowledge of the healthcare industry, specifically the pharmacy industry,…