Pharmacy Billing Specialist - Rx Logistics - Full Time - Days

REPORTING RELATIONSHIPS/SUPERVISORY RESPONSIBILITIES

Will report directly to the Director of Pharmacy. Will interact regularly with pharmacy staff, pharmacy business analysts, and corporate finance.

POSITION SUMMARY

This position will be responsible for ensuring timely and accurate payment to pharmacy for products and services. Additionally, the position will be responsible for monitoring, resolving, and preventing any issues that lead to non-payment.

ACCOUNTABILITIES

*All duties listed below are essential unless noted otherwise*

• Cash posting and reconciliation of pharmacy claims via remittance detail, both electronic and manual, utilizing Central Pay and other mechanisms.
• Monitoring and resolution of non-payments and variances in remittance detail to optimize reimbursement.
• Develop and maintain controls, processes, and procedures to ensure prompt and accurate payment of pharmacy claims. Provides feedback to Director for staff education needed to improve billing and/or compliance issues.
• Responsible for maintenance of the Accounts Receivable reports to meet established A/R goals.
• Assist pharmacy staff with medical billing of medications.
• Maintenance of pharmacy charge accounts for patients, cross-charges within ProMedica, and refunds.
• Performs other duties as directed.

REQUIRED QUALIFICATIONS

Education: High School diploma or GED

Skills: Pharmacy billing; Excel/Word; Experience with pharmacy benefit managers (PBM).

Years of Experience: N/A

License: N/A

Certification: N/A

PREFERRED QUALIFICATIONS

Education: N/A

Skills: Medical billing

Years of Experience: 2+ in pharmacy or pharmacy billing

License: Pharmacy Technician

Certification: N/A

WORKING CONDITIONS

Personal Protective: N/A

Physical Demands: Extended periods of sitting; frequent computer and telephone usage.

The above list of accountabilities is intended to describe the general nature and level of work performed by the incumbent; it should not be considered exhaustive.

ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio.  For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace