Pharmacy Pre-Billing Specialist at CSI Companies

Nash, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Mar, 26

Salary

0.0

Posted On

20 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Verification, Prior Authorization, Claim Submission, Data Entry, Billing, Communication, Customer Service, Multi-tasking, Confidentiality, Compliance, Research, Office Functions, Healthcare Knowledge, Teamwork, Problem Solving, Professionalism, Adaptability

Industry

Hospitals and Health Care

Description

Job Title Pharmacy Pre-Billing Specialist Location Nash, TX, USA Additional Location(s) Employee Type Employee Working Hours Per Week 40 Job Description Summary This position will be responsible for reviewing the quality of work produced by the referral management and intake teams. Information and materials generated from these departments will be for final review by the Intake Director and Quality Control Coordinator. Including, but not limited to, verification of customer insurance, healthcare claim submissions, PDP and Medical prior authorizations, and other related work produced. Direct communication with insurance organizations may be required. Essential Duties and Responsibilities include the following. Other duties may be assigned, as necessary. Reviews insurance operational areas: Insurance Verification and entry into Care Tend Prior Authorization completion in CT Preparation for Claim Submission Intake Workflow Copay Assistance / billing Insurance software Performs a variety of office functions, such as filing, typing, copying, data entry, research, etc., to support various b Maintains various Billing files in proper order billing and financial operations. Nursing Software/Nursing Note Submission & Nurse tracking. Billing preparations for nursing notes Adheres to confidentiality, safety, compliance, and legal requirements. Ongoing Communication with Referral Management, Billing, Insurance Verification, and Data Entry. Assists in appropriate product selection by understanding all payers, reimbursement, and formularies. Comply with company deadlines and inventory to meet both the company and its compliance standards. Consistently represents the company in a professional manner. Maintains effective working relationship and cooperates with all personnel in the Company. Participate in administrative staff meetings and attend other meetings and seminars. Performs other related duties as assigned or requested. Qualification Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Provides the highest level of professionalism, responsiveness, and communication to build and maintain the maximum customer base possible. Possesses the ability to multi-task and frequently change direction as required. Education and/or Experience A High School Diploma or equivalent GED is required, at minimum. College or technical college preferred 3 - 5 years medical experience. Ability to work independently and within a multidisciplinary team. Minimum two years in healthcare environment/industry Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or listen. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions. Comments This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time. NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana. By supplying your phone number, you agree to receive communication via phone or text. CSI Pharmacy is an Equal Opportunity Employer CSI Pharmacy We’re a nationwide specialty pharmacy, founded by pharmacists and dedicated to providing services for patients with chronic and rare illnesses that require complex care. We are invested in improving the health, and the lives, of the people we serve by offering expert clinicians, passionate advocates, committed healthcare partners, and strategic reimbursement experts. Our goal is to optimize patient outcomes while treating patients as if they were members of our family. Every employee – from those who work with our patients in the field, to those who support them in administrative and office roles – is valued, respected, and encouraged to grow. CSI Pharmacy is an Equal Opportunity Employer Privacy Statement Providing complex therapies to patients in the home setting is a long-term commitment for our CSI Pharmacy staff. Not only do we work hard to ensure all of our patients receive the highest level of care and comfort, but we also love getting to know our patients personally and sharing their sense of success when their condition improves. Here are some of the folks you may meet on your journey with us.

Responsibilities

The Pharmacy Pre-Billing Specialist is responsible for reviewing the quality of work produced by the referral management and intake teams, including verification of customer insurance and healthcare claim submissions. This role requires direct communication with insurance organizations and maintaining effective working relationships with various personnel.