Pharmacy Billing Specialist – Claims Resolution, Denials
Indiana Hemophilia & Thrombosis Center, Inc.
full-time
Posted on:
Location Type: Hybrid
Location: Indianapolis • United States
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About the role
- Assist in the preparation and submission of pharmacy claims to third party insurance carriers, if and when necessary.
- Secure appropriate medical documentation as required by third party insurance carriers.
- Follow up with third party insurance carriers and patients on unpaid claims or balances.
- Research payer regulations and claim guidelines regarding claim payment and denial management criteria to ensure compliant billing practices by utilizing website and associated tools established by payers as applicable.
- Assist in verification of insurance coverage for pharmacy services prior to services being rendered, if applicable.
- Re-verify benefit coverage criteria as needed for claims follow up.
- Ensure accurate and thorough documentation of steps taken to resolve claim issues are recorded in billing software(s).
- Communicate claim issues to Billing Manager on a regular basis.
- Work with Billing Manager to establish weekly, monthly, annual goals and communicate associated progress as needed.
Requirements
- - High school diploma or GED
- - Minimum 3 years of experience in hospital or medical setting
Benefits
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Applicant Tracking System Keywords
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Hard Skills & Tools
pharmacy claims processingmedical documentationclaim payment managementdenial managementinsurance verificationbilling software documentation
Soft Skills
communicationproblem-solvingorganizational skillsgoal setting
Certifications
high school diplomaGED