Billing Specialist managing pharmacy and medical claims, rejections, payer communication, and patient billing at Reliance Rx Specialty Pharmacy. Supports deliveries, portals, prior authorizations, and financial assistance coordination.
Responsibilities
Responsible for billing all claims (pharmacy and medical) and managing rejections to ensure appropriate follow up and delivery promise times are met
Act as a liaison between patients and insurance companies, and facilitate communication between patients and doctors, medical staff and administrative staff
Work with payors to resolve any billing issues
Ensure Reliance Rx is following CMS guidelines per Medicare and Medicaid guidance
Confirmation of billing accuracy and payor billing/shipping requirements
Process and set up deliveries to medical offices
Medical claims billing for both supplies and medications
Confirm financial aspects of the claims prior to them leaving the facility
Portal management including refill reminders, processing orders from the portal, and completing patient registrations
Financial assistance coordination with patients for foundation care, copay assistance, or free medication programs where applicable
Assist the Patient Care Specialists in workflow and with incoming and outgoing calls, maintaining patient records, filing and documentation duties
Set up and data entry, financial arrangements and collecting co-payments
Prior authorization assistance with offices and coordination of benefits
Promote information sharing and continuous process improvement
Function in strict accordance with standard, written procedures and guidelines with deviation approved by the supervising pharmacist
Requirements
High school diploma or GED required
National Pharmacy Technician Certification (CPhT) preferred
One (1) year of experience working in a high-volume pharmacy, or equivalent setting, required, or six (6) months as a temporary associate in the Reliance Rx Operations & Compliance department
Experience working with online claims processing system preferred
Effective oral and written communication skills and an aptitude for working with other health care professionals
Ability to lift a minimum of 5 lbs
Proven examples of displaying the Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive
Immigration or work visa sponsorship will not be provided for this position
Benefits
first-class perks, benefits and a culture that fosters growth, innovation and collaboration
associates may be eligible for a scorecard incentive
full range of benefits
generous paid time off
reasonable accommodations for qualified individuals with disabilities and disabled veterans
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