Medical Billing Specialist

Overview

Job Summary: Responsible for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate financial and clinical information to appropriate stakeholders (internal and external) to ensure payment for services.

 

Travel: Limited travel may be required. Travel to healthcare providers and to various business and management conferences required. Travel to Facilities for periodic training and review.

 

Scope of Responsibilities: Works under minimal supervision.  Follows standard procedures to accomplish assigned tasks.  Establish, manage, and communicate the process of billing medical claims for specialty facilities.

Responsibilities

Job Duties:

 

• Manages the existing process of medical billing in the specialty pharmacy space to ensure prompt submission and reconciliation of claims from specialty facilities.
• Collaborate with leadership to enhance and grow the medical billing process for all facilities.
• Provide timely reporting, feedback, and information to support the business operation and medical billing functions as necessary
• Provide insights regarding trends in medical billing to operations team
• Follow, create and improve the Policies and Procedures necessary to improve the functionality of the medical billing process.
• Knowledge of Excel spreadsheets is also essential.
• Possess strong accounting and organizational skills to effectively manage and maintain systems and processes associated with the position.
• Coordination with other pharmacy and finance staff for proper financial reporting of billing and receipts and clerical responsibilities as needed to include copying and filing
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Qualifications

Educational Requirements:

 

• Minimum: High School Diploma or GED
• Preferred: Medical Billing/Coding certification, Pharmacy technician or related certification

 

Experience: 

 

• Past experience in a customer service-related field
• Past experience in medical billing environment
• 12-24 months experience as a pharmacy technician

 

 

Attendance Requirements:

 

• Must be available, and on-time for scheduled work shifts.
• Must be able to work nights and weekends as required.

 

Job Skill Requirements:

 

• Broad knowledge of medications, physician orders, and pharmacy systems
• Strong communication skills
• Outstanding customer service skills
• Excellent organization skills
• Ability to multitask and prioritize
• Excellent computer and keyboarding skills
• Excellent Excel skills
• Successful completion of a pre-employment and/or random drug screening test

 

 

Compensation

 

$19 - 20.64 per hour.

 

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.  

 

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.