GreenShield Administration provides innovative health benefit solutions for the small-mid size companies in Canada. Recognized as the leading alternative to the traditional insurance companies, in a market where small and mid-sized employers have been largely underserved GreenShield Administration sets itself apart from the competition, by using technology, creative product development and a stellar customer experience to solve problems for employers. Honeybee Benefits is our next generation benefits platform built for today’s modern workforce that empowers employers to compete better for talent. 

Scoping across all GreenShield Specialty Pharmacies, the Specialty Pharmacy Billing Specialist is a patient-facing role focused on coordinating out of pocket payments with patients and Patient Support Programs (PSPs) and updating profiles in the pharmacy software, Kroll. This role serves as a key liaison between the pharmacy, Patient Support Programs (PSPs), and third-party insurers to reconcile payments, resolve billing discrepancies, collect payments, and manage retroactive billing (retro-billing) processes. 

• Manage Specialty Pharmacies’ patient AR accounts, including following up with patients via phone calls and emails to collect outstanding amounts and provide guidance through the provincial plans and PSP Portals   
• Organizing and submitting co-pay amounts to PSPs using Kroll software   
• Reconciling payments received from PSPs and patients with their Kroll accounts   
• Supporting the Specialty Pharmacies with Retrobilling, including assessing if/when insurance coverage is established, backdating any applicable claims through the pharmacy software within acceptable window, invoicing PSPs for medications used to bridge patient while coverage was pending   
• Supporting the Specialty Pharmacies with billing optimization initiatives ensuring all claims are being submitted appropriately and efficiently  

WHO WE'RE LOOKING FOR

We're not looking for just anyone. We’re looking for a unique individual with a big brain and a big heart who wants to help us create better health for all Canadians.  

• +5 years as a pharmacy assistant in Specialty Pharmacy 
• +3 years in bookkeeping, accounting or invoicing in a pharmacy or healthcare setting 
• Experience working with PSP and third party payment portals 
• Understanding co-pays, deductibles, and out-of-pocket costs 
• Understanding PSPs and the Retrobilling process 
• Understanding how to navigate Trillium and other public plans 
• Patient payment collection (following up with patients, clearly explaining co-pays / deductibles) 
• Claims submission & PSP Management (submitting and tracking payments, logging claim statuses and escalations, following up on delayed or denied claims) 
• Retro-billing and Corrections (billing discrepancies and timely reimbursement) 

NICE TO HAVE

• Experience with Kroll considered an asset 
• Experience in patient collections and third party billing 
• Experience working with PSP and third party payment portals 
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GreenShield Administration provides innovative health benefit solutions for the small-mid size companies in Canada. Recognized as the leading alternative to the traditional insurance companies, in a market where small and mid-sized employers have been largely underserved GreenShield Administration sets itself apart from the competition, by using technology, creative product development and a stellar customer experience to solve problems for employers. Honeybee Benefits is our next generation benefits platform built for today’s modern workforce that empowers employers to compete better for talent. 

Scoping across all GreenShield Specialty Pharmacies, the Specialty Pharmacy Billing Specialist is a patient-facing role focused on coordinating out of pocket payments with patients and Patient Support Programs (PSPs) and updating profiles in the pharmacy software, Kroll. This role serves as a key liaison between the pharmacy, Patient Support Programs (PSPs), and third-party insurers to reconcile payments, resolve billing discrepancies, collect payments, and manage retroactive billing (retro-billing) processes. 

• Manage Specialty Pharmacies’ patient AR accounts, including following up with patients via phone calls and emails to collect outstanding amounts and provide guidance through the provincial plans and PSP Portals   
• Organizing and submitting co-pay amounts to PSPs using Kroll software   
• Reconciling payments received from PSPs and patients with their Kroll accounts   
• Supporting the Specialty Pharmacies with Retrobilling, including assessing if/when insurance coverage is established, backdating any applicable claims through the pharmacy software within acceptable window, invoicing PSPs for medications used to bridge patient while coverage was pending   
• Supporting the Specialty Pharmacies with billing optimization initiatives ensuring all claims are being submitted appropriately and efficiently  

WHO WE'RE LOOKING FOR

We're not looking for just anyone. We’re looking for a unique individual with a big brain and a big heart who wants to help us create better health for all Canadians.  

• +5 years as a pharmacy assistant in Specialty Pharmacy 
• +3 years in bookkeeping, accounting or invoicing in a pharmacy or healthcare setting 
• Experience working with PSP and third party payment portals 
• Understanding co-pays, deductibles, and out-of-pocket costs 
• Understanding PSPs and the Retrobilling process 
• Understanding how to navigate Trillium and other public plans 
• Patient payment collection (following up with patients, clearly explaining co-pays / deductibles) 
• Claims submission & PSP Management (submitting and tracking payments, logging claim statuses and escalations, following up on delayed or denied claims) 
• Retro-billing and Corrections (billing discrepancies and timely reimbursement) 

NICE TO HAVE

• Experience with Kroll considered an asset 
• Experience in patient collections and third party billing 
• Experience working with PSP and third party payment portals