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Hybrid Pharmacy Billing Specialist – Claims Resolution, Denials
Posted 3 weeks ago
About the role
- Pharmacy Billing Specialist managing pharmacy claims for a leader in hemophilia care. Preparing claims, securing documentation, and following up on unpaid balances in a hybrid role.
Responsibilities
- Assist in the preparation and submission of pharmacy claims to third party insurance carriers, if and when necessary.
- Secure appropriate medical documentation as required by third party insurance carriers.
- Follow up with third party insurance carriers and patients on unpaid claims or balances.
- Research payer regulations and claim guidelines regarding claim payment and denial management criteria to ensure compliant billing practices by utilizing website and associated tools established by payers as applicable.
- Assist in verification of insurance coverage for pharmacy services prior to services being rendered, if applicable.
- Re-verify benefit coverage criteria as needed for claims follow up.
- Ensure accurate and thorough documentation of steps taken to resolve claim issues are recorded in billing software(s).
- Communicate claim issues to Billing Manager on a regular basis.
- Work with Billing Manager to establish weekly, monthly, annual goals and communicate associated progress as needed.
Requirements
- High school diploma or GED
- Minimum 3 years of experience in hospital or medical setting
Benefits
- IHI is a not-for-profit program based in Indianapolis and offers a competitive salary and benefit package.
- IHI is the only ederally designated comprehensive hemophilia program in Indiana, and serves the entire state through services available in Indianapolis and at outreach clinics.
- IHI is a leader in hemophilia care, education and clinical research and has a dedicated on-site multidisciplinary staff to ensure availability of a wide range of required services.
- IHI participates in national and international clinical research, including new infusion products and therapies, investigation of long-term outcomes, and the impact of associated conditions. The IHTC research program provides patients access to new therapies, and an opportunity to improve care. Our center has more than 70 clinical research projects involving bleeding disorders, sickle cell disease, thrombosis and more.
- The Indiana Hemophilia and Thrombosis Center is an Equal Opportunity Employer.
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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