Overview:
The Pharmacy Collections Specialist supports pharmacy revenue cycle and accounts receivable operations by managing collection activities, resolving billing issues, and maintaining accurate responsible party information. This role works with patients, responsible parties, pharmacy personnel, and internal departments to support cash collections, account resolution, and payment recovery efforts. The Pharmacy Collections Specialist helps ensure timely collection of outstanding balances, accurate patient account management, regulatory compliance, and effective business office operations.
Responsibilities:
- Conduct collection calls and written correspondence to support recovery of outstanding patient account balances.
- Verify and maintain accurate responsible party information within pharmacy patient accounting systems.
- Request and obtain additional information from patients, responsible parties, pharmacy staff, and internal departments to resolve billing discrepancies and account issues.
- Provide customer service related to collections, account adjustments, refund processing, and payment inquiries.
- Monitor and maintain assigned accounts through collection activities, account reconciliation, adjustment processing, credit requests, and refund requests.
- Work to reduce delinquent accounts and improve collection outcomes for assigned account portfolios.
Collaborate with pharmacy leadership and seek guidance when necessary to ensure accurate application of billing, collections, reimbursement, and compliance requirements.
- Communicate account status updates effectively with responsible parties, management, business office personnel, and internal or external stakeholders.
- Process and distribute delinquency notices and related collection communications.
- Investigate and reconcile patient account disputes related to outstanding balances and payment activity.
- Maintain accounts receivable documentation and provide operational reports as requested by pharmacy leadership.
- Maintain knowledge of applicable billing, collections, payor, regulatory, and compliance requirements affecting pharmacy collection activities.
- Adhere to internal controls and support compliance with applicable federal, state, accreditation, and healthcare plan requirements.
- Participate in business office and pharmacy meetings, support patient and resident safety initiatives, and perform other duties as assigned.
Compile and prepare daily, weekly, monthly, and ad hoc collection reports to support business office and pharmacy leadership decision-making.
Maintain confidentiality of protected health information (PHI) and comply with HIPAA privacy, security, and documentation requirements.
Qualifications:
- At least three years of healthcare collections experience is required.
- Experience in a pharmacy, medical business office, or hospital environment.
- Experience with revenue cycle management, accounts receivable processes, pharmacy billing, or medical billing operations is preferred.
- Accounts receivable and medical billing knowledge or experience preferred.
- Computer literacy required.
- Proficiency in mathematics, written communication, and verbal communication skills.
- Ability to manage multiple priorities and perform effectively in potentially stressful situations.
- High school diploma required; college degree or equivalent advanced coursework in office management preferred.
Benefits/EEO:
What We Offer You
- Competitive Wages
- 401k with match
- Medical, Dental, Vision & Supplemental Insurance
- Vacation, Sick, Personal Holiday & Paid Holidays
- Short-Term Disability
- Life Insurance
- Tuition & CEU Reimbursement
- Rewards & Recognition Program
EEOC
We are an Equal Opportunity Employer. We offer an excellent benefit plan to include 401(k) with match, CEU reimbursement, vacation, sick time, holidays, medical, dental, and supplemental insurance plans, as well as a highly competitive compensation package.