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Billing Representative

Partner Pharmacy NEWSpringfield🇺🇸United States

Quick overview

SeniorityMid Senior
Work modeHybrid
LocationSpringfield, United States
CompliancePharmacyReconciliation

Job description

Great new Career Opportunity in Long-Term Care Pharmacy!

Now Hiring - Billing Representative - Springfield, NJ

Hours: M – F 8:30 – 5:00

The Billing Representative will be responsible for, but not limited to:

  1. Respond to all voice messages and emails within 24-48 hours
  2. Track and enter daily census for assigned facilities.
  3. Update the system with face sheet information for residents in their assigned facilities.
  4. Handle facility and customer service inquiries.
  5. Review and update system with resident information received from returned contracts for assigned facilities.
  6. Handle re-bill rejections resulting from status changes for assigned facilities.
  7. On a monthly basis, handles all aspects of facility and private billing for assigned facilities.
  8. On a monthly basis, contacts Unysis, CMS, and facilities to follow up on pending Medicaid statuses.
  9. On a weekly/bi-weekly basis, review the pre-billing report for their assigned facilities
  10. Maintains and fosters positive work environment within the billing and admissions departments.
  11. Communicates effectively with all company personnel.
  12. Aware of all compliance documentation needed for Medicare B Billing requirements.
  13. Follow Up procedures-needs to be able to follow up with doctors and facilities for necessary Medicare B compliance documentation
  14. Reconcile claims including secondary claims
  15. Research the different reconciliation for each state
  16. Keep complete files for each Med B patient.
  17. Participates in ongoing education and new compliance issues for appropriate billing of Medicare B claims
  18. Maintains confidentiality, security and integrity of PHI information
  19. Need to communicate any issues to Third Party manager that need to be addressed or any issues that need to be resolved.

Education:

High School Diploma or equivalent

Professional Experience:

  • Experience in long term care or retail pharmacy environment
  • 1-3 yeas of Billing experience
  • Experience in Frameworks, a definite plus
  • Communication, problem solving and organizational skills a must
  • Must be able to work in a fast pace environment and meet deadlines
  • Typing, computer and multi-tasking skills are a must
  • Strong customer service skills

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