North Canton, OH30+ days ago
Responsibilities: • Perform Billing duties as needed • Understand the pharmacy front-end process and perform point of sale functions (adjudication) • Contact payors and/or other outside agencies to verify information and resolve common, non-clinical problems • Run weekly billing reports • Obtain accurate billing and resident information, and rebill and resolve unpaid claims through adjudication • Re-bill and reconcile all incorrectly billed, non-clinical third-party denials • Identify and resolve and process denied claims in a timely manner • Document all communication concerning denied claims and any resolution communicated to facility or physicians • Obtain Prior Authorizations and non-covered forms • Obtain Part B documentation • Assist with billing DME supplies on line (Medicaid) • Resolve Hospice denials and communicate to Hospice nurses any denied claims • Adhere to and demonstrate mastery of current operating procedures • Use DocuTrack skills to locate specific documents and fax documents to facilities and/or for audit purposes • Stay in line with End of Month processes and deadlines • Ensure customer requests are handled quickly and professionally • Communicate effectively with customers to resolve billing inquiries • Communicate effectively with third party payors to resolve denied claims • Complete and verify pricing requests for customers • Direct specific inquiries to the appropriate team/individual • Maintain a positive, pleasant demeanor with all customers • Utilize robust problem-solving and people skills, patience, and telephone etiquette • Document customer issues using CPAS form and communicate to management • Work with Billing/Collection Managers on special projects as needed • Other duties as assigned. Qualifications: • Active pharmacy technician license from the Ohio State Board of Pharmacy preferred • Previous pharmacy experience extremely valuable and desired • At least 1 year of billing experience • Proficient in Microsoft word and Excel.