HybridHybrid position with onsite attendance required at the Williamsville location.
Medical, Clinical & VeterinaryClinical Support & Patient Administration
No H1B Sponsorship
About the job
Requirements
A high school diploma or GED is required.
One year of experience working in a high-volume pharmacy or equivalent setting is required, or six months as a temporary associate in the Reliance Rx Operations & Compliance department.
Effective oral and written communication skills and the ability to work with other health care professionals are required.
The ability to lift a minimum of 5 pounds is required.
The candidate must demonstrate the Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive.
Responsibilities
Complete billing for pharmacy and medical claims and adjudicate rejections.
Manage claim rejections and follow up to ensure delivery promise times are met.
Act as a liaison between patients and insurance companies, and facilitate communication between patients, doctors, medical staff, and administrative staff.
Work with payors to resolve billing issues.
Ensure Reliance Rx follows CMS guidelines and Medicare and Medicaid guidance.
Confirm billing accuracy and payor billing and shipping requirements.
Process and set up deliveries to medical offices.
Bill medical claims for supplies and medications.
Confirm the financial aspects of claims before they leave the facility.
Manage the portal, including refill reminders, processing portal orders, and completing patient registrations.
Coordinate financial assistance with patients for foundation care, copay assistance, or free medication programs where applicable.
Assist Patient Care Specialists with workflow and incoming and outgoing calls according to business needs, including maintaining patient records, filing and documentation, setup and data entry, financial arrangements and copayment collection, prior authorization assistance with offices, and coordination of benefits.
Promote information sharing and continuous process improvement.
Follow standard written procedures and guidelines; obtain approval from the supervising pharmacist for deviations.
Desired Qualifications
National Pharmacy Technician Certification (CPhT) is preferred.
Experience working with an online claims processing system is preferred.
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We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.
Overview
The Billing Specialist assists with the various activities of the pharmacy operations not requiring the professional judgment of the pharmacist. The Billing Specialist is primarily responsible for completing the billing of both pharmacy and medical claims and adjudicating rejections.
Qualifications
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.
Essential Accountabilities
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 in accordance with business needs, to include but not limited to:
maintaining patient records; filing and documentation duties.
set up and data entry.
financial arrangements and collecting co-payments.
prior authorization assistance with offices.
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.
This is a hybrid position with onsite attendance required at our Williamsville location.
Immigration or work visa sponsorship will not be provided for this position
Hiring Compensation Range: $22.50 - $23.50 hourly
Compensation may vary based on factors including but not limited to skills, education, location and experience.
In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.
As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click herefor additional EEO/AAP or Reasonable Accommodation information.
Current Associates must apply internally via the Job Hub.