Director of Purchasing and Inventory at MedWiz Pharmacy

Lexington, Kentucky, United States -

Full Time

Start Date

Immediate

Expiry Date

11 Jun, 26

Salary

0.0

Posted On

14 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Billing, Collections, Insurance Claims Processing, Payment Posting, Accounts Receivable Management, HIPAA Compliance, Customer Service, Data Entry, Financial Reporting, Negotiation, Claim Rejection Resolution, Insurance Verification

Industry

Pharmaceutical Manufacturing

Description

Description Must be available to work on site in Louisville or Lexington, KY Job Summary: The Billing Collections Specialist in a pharmacy plays a crucial role in ensuring the accurate and timely collection of payments from insurance companies, patients, and other third-party payers. This position requires strong attention to detail, excellent communication skills, and a solid understanding of insurance billing processes and regulations. The primary responsibility of a Billing Collections Specialist is to maximize revenue by minimizing outstanding balances and resolving billing discrepancies. Duties and Responsibilities: 1. Billing and Claims Processing: - Generate and submit accurate insurance claims to various payers, including private insurance companies, Medicare, and Medicaid. - Verify patient insurance coverage, benefits, and eligibility. - Review claims for accuracy, completeness, and compliance with insurance requirements and pharmacy policies. - Resolve claim rejections, denials, and other billing errors. - Follow up with insurance companies to ensure prompt payment of outstanding claims. 2. Collections and Payment Posting: - Monitor and manage outstanding accounts receivable. - Contact patients, insurance companies, and other third-party payers to collect overdue payments. - Negotiate payment arrangements and develop repayment plans, when necessary. - Post payments accurately to patient accounts and reconcile discrepancies. - Investigate and resolve billing discrepancies and disputes. 3. Customer Service: - Provide excellent customer service to patients, healthcare providers, and insurance representatives. - Respond to inquiries regarding billing and insurance claims status. - Address patient concerns and assist in resolving billing-related issues. 4. Compliance and Documentation: - Maintain patient confidentiality and adhere to HIPAA regulations. - Ensure compliance with federal and state laws and regulations related to billing and collections. - Document all communication and activities related to billing and collections accurately and thoroughly. 5. Financial Reporting: - Prepare and analyze reports related to accounts receivable, collections, and aging of outstanding balances. - Identify trends and areas for improvement in billing and collections processes. - Provide regular updates and reports to the pharmacy management team. Requirements Qualifications and Skills: - High school diploma or equivalent (some employers may require an associate's or bachelor's degree). - Previous experience in medical or pharmacy billing, collections, or healthcare finance preferred. - Knowledge of insurance billing processes, reimbursement policies, and medical coding systems (e.g., CPT, ICD-10). - Familiarity with pharmacy claims processing software and electronic health records (EHR) systems. - Strong understanding of insurance regulations, including Medicare and Medicaid guidelines. - Excellent communication and interpersonal skills for effective interaction with patients, healthcare providers, and insurance representatives. - Attention to detail and accuracy in data entry, record-keeping, and financial reporting. - Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment. - Proficiency in using office software (e.g., Microsoft Excel, Word) and billing software applications. Note: This job description is a general overview of the typical duties and responsibilities of a Billing Collections Specialist in a pharmacy setting. The specific job requirements and responsibilities may vary depending on the organization, size of the pharmacy, and regional regulations.

Responsibilities

The primary duties involve generating and submitting accurate insurance claims, verifying coverage, resolving claim rejections, and managing outstanding accounts receivable through collections activities. This role also requires monitoring payments, posting transactions accurately, and providing excellent customer service regarding billing inquiries.