BrightSpring Health Services

MED D BILLER REPRESENTATIVE

Job Locations US-TX-ARLINGTON
ID
2020-3913
Line of Business
PharMerica

Our Line of Business

PharMerica logo_no tag

Overview

Accelerate your career!  We apply innovative solutions that improve patient outcomes through some of the industry’s best and brightest business professionals, innovators and clinicians.  Right now, we have an exciting opportunity for you to join our team as a Med B Biller Representative.

Responsibilities

  • Acts as a resource to the facilities in obtaining information, completing necessary documentation, and following up on outstanding claims.
  • Understands Insurance and Medicaid formularies and processes, including the prior authorization processes.
  • Makes outgoing calls to Facilities, Plans, and Physician’s offices as needed to obtain approvals
  • Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to effectively communicate and resolve customer issues.
  • Provides clinical support to members of the RxAllow team regarding prior authorization concerns
  • Achieves productivity goals with regard to calls/claims per hour, as determined by the Director and Clinical Hub Manager.
  • Prioritizes work to meet daily and competing deadlines.
  • Develops a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow.
  • Maintains a clean and organized work area.
  • Performs other tasks as assigned.

Qualifications

Education/Learning Experience:

  • Required:  HS Diploma or equivalent experience.
  • Desired:  Associate degree/ Bachelor’s Degree.

 Work Experience:

  • Required:  Third Party Medical Billing Experience.
  • Desired:  1-3 years pharmacy experience; 3 years call center experience.

 Skills/Knowledge:

  • Required:  Familiar with the claim adjudication process.  Proficiency in Microsoft Office.
  • Desired:  Understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow.

Licenses/Certifications:

  • Required:  Certified Pharmacy Technician.

Behavior Competencies:

  • Required:  Interpersonal Skills, Oral Communication, Written Communication, Teamwork, Ethics, Organizational Support, Judgment, Planning/Organizing, Professionalism, Adaptability, Initiative.

About our Line of Business

PharMerica is a full-service pharmacy solution providing value beyond medication.  PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations.  PharMerica is one of the nation's largest pharmacy companies.  PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades.  For more information about PharMerica, please visit www.pharmerica.com.  Follow us on FacebookTwitter, and LinkedIn.

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