Pharmacy Billing Associate at PCA Virginia Area

Louisville, Kentucky, United States -

Full Time

Start Date

Immediate

Expiry Date

15 May, 26

Salary

0.0

Posted On

14 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Billing, Customer Service, Medicare, Medicaid, Insurance Verification, Claim Submission, Claim Follow-up, Dispute Resolution, Prior Authorization, Compliance, Data Accuracy, Pharmacy Operations

Industry

Hospitals and Health Care

Description

Overview Careers close to home and your heart Since our founding in 1997, we’ve been making long-term care better for our residents and more rewarding for our team members. We’re a Fortune Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor’s Top 100 Best Companies to Work. If you’re looking for a place that embraces you for who you are, helps you achieve your full potential, and makes working hard feel less like hard work, then look no further than Trilogy. Responsibilities Are you compassionately committed to customer service? If so, we would like to hear from you!Synchrony Pharmacy, a subsidiary of Trilogy Health Services LLC, is seeking a Pharmacy Billing Associate for the Pharmacy divison. We invite you to learn more about our unique culture and the exciting opportunities that exist within our organization. Qualifications Hours : 2nd Shift ( 1:00 PM- 9:30 PM or 2:00 PM - 10:30 PM) Job SummaryProcesses and ensures the accuracy and timely issuance of invoices to customers. Provides health careprofessionals with assistance with Medicare, Medicaid, Prescription Drug Plans (PDP’s) and Third-PartyInsurances. Roles and Responsibilities• Generate and submit claims to insurance providers.• Verify the accuracy of prescription orders, patient information, and insurance details before billing.• Monitor claim status and follow up on rejected or denied claims.• Address billing inquiries, resolve disputes, and provide exceptional customer service.• Investigate and resolve billing discrepancies and issues with insurance claims.• Collaborate with the pharmacy team to resolve complex billing-related problems.• Ensure compliance with all billing guidelines and regulations.• Verify patient insurance coverage, eligibility, and benefits.• Address any discrepancies in coverage and communicate with patients or facilities when needed.• Request prior authorization on drugs that are denied for prior authorization.• Notify facilities of changes and exceptions when appropriate.• Other duties as assigned. QualificationsEducation: High School / GEDExperience: 1-3 years Licenses and CertificationsCertified Pharmacy Tech preferred Physical Requirements Sitting, standing, bending, reaching, stretching, stooping, walking, and moving intermittently duringworking hours. Must be able to lift at least 50lbs. Must be able to maintain verbal and writtencommunication with co-workers, supervisors, residents, family members, visitors, vendors, and allbusiness associates outside of the health campus.

Responsibilities

The primary duties involve processing invoices accurately and ensuring timely issuance to customers, while also assisting healthcare professionals with inquiries related to Medicare, Medicaid, and various insurance plans. Responsibilities include generating and submitting claims, monitoring status, resolving rejections, and investigating billing discrepancies.