Billing Specialist I

　　Monroeville, PA

　　Temporary

　　M-F 8am-4:30pm-Location: Must be 1 hour from Monroeville PA-Do you have Minimum 1 year experience performing healthcare reimbursement, medical insurance/billing or related work. Do you have Minimum 1 year experience working withHybrid: The requirement right now is 1 day a month (each team has a set date). Will need to be willing to be onsite as needed.

　　On their first day, they will come into the office and as long as their laptop is ready for them, we will send them home with all equipment that same day. workers will be training onsite and then it will be determined if they should stay on site or WFH pending performance

　　Summary:

　　CVS Health, Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full-time billing/collections representative. The Pharmacy Billing/Collections Representative will ensure timely and accurate billing for unbilled claims and ensure account payment for outstanding balances while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers.

　　Billing Specialist I will be responsible for qualifying, preparing and submitting claims to ECS billing. Individual must work with LTC facility staff, Omnicare pharmacy operations staff, prescriber offices, third party payers, patients and/or their responsible parties and claim processors. This position requires work within several different operating systems and web based programs to retrieve document images, collect supporting or additional information on fills and work claims through to resolution to ensure compliant, timely and accurate billing practices.

　　Key Responsibilities of the Pharmacy Billing Representative:

　　• Third Party insurance claim billing and follow up associated with the dispensing of prescription medication using the bill method required by the payer.

　　• Transmit or submit claims (paper, electronic) to insurance payers for reimbursement.

　　• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.

　　• Maintain supporting chronological notes that detail actions taken to resolve outstanding unbilled claims.

　　• Maintain patient demographic information in data collections systems.

　　• Work all billing reports and queues while remaining in accordance with payer and company policy guidelines.

　　• Research and respond by telephone, via the internet and in writing to patients, physician's offices, insurance companies and governmental payers regarding billing issues and problems as well to expedite claims processing.

　　Preferred Qualifications :

　　• Customer service in healthcare environment.

　　• Experience working with a healthcare reimbursement system preferred.

　　• Ability to communicate with clientele in a professional manner; both verbally and written.

　　• Attention to detail.

　　• Ability to utilize analytical skills.

　　• Effective customer service skills and experience that shows ability to work in a team environment.

　　• Experience in MS Office, specifically Excel, Outlook, and Word

　　Qualifications:

　　Minimum 1 year experience performing healthcare reimbursement, medical insurance/billing or related work. Pharmacy billing preferred.

　　Minimum 1 year experience working with healthcare reimbursement systems.

　　Ability to prioritize daily tasks.

　　Working knowledge of medical terminology.

　　Customer service skills with the ability to work in a team environment.

　　Experience in MS Word, Excel and Outlook.

　　Strong communication, interpersonal, and prioritization skills Must be highly organized and detail-oriented. Ability to work in a fast paced, rapidly changing environment Good computer skills requiring basic knowledge of Microsoft Word, Excel, PowerPoint, Outlook and good typing skills.

　　Education:

　　Verifiable High School diploma or GED is required.