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Billing Representative I Pharmacy

Company: Advocate Christ Medical Center
Location: Sheboygan
Posted on: August 3, 2022

Job Description:

Billing Representative I Pharmacy Job ID: R16393 Shift: 1st Full/Part Time: Full_timeLocation: 2307 S Business Dr Sheboygan, WI 53081Benefits Eligible: Yes Hours Per Week: 40Schedule Details/Additional Information:

  • Monday to Friday 8:00am to 4:30pm
  • Positionis a blended work model with being mostly remote but will require to be in office one day per week, occasionally more dependent on responsibilities.Reconciles and posts payments. Monitors simple to moderately complex assigned accounts, corrects billing errors, identifies delinquent payments and re-submits as necessary. Conducts prompt collection of accounts receivable and resolution of problems that are delaying payment.Posts payments and reviews assigned accounts for any internal or external problems that may cause a delay in payment. Analyzes available information and decides course of action.Contacts insurance companies or any other person, organization or department whose assistance is needed to obtain payment of pharmacy claim, until it is paid or rejected.Responds to telephone or written inquiries from insurance companies, employers, state agencies and patients regarding insurance claims. Process rejections by billing the patient; or resolving problems, and having the claim resubmitted for payment. Applies contractual allowances where necessary.Acts as a resource person for the pharmacies on all issues relating to the assigned insurance type: i.e., commercial, HMO or government agency. Updates Manager and co-workers on all changes and new procedures. Maintains a basic knowledge of any contracts relating to assigned insurances. Notifies Manager and/or Lead of any contract issues that arise.Evaluates aged claims for probability of payment and refers those unlikely to be paid to collection as necessary.Required Functional Experience
    • Typically requires 1 year of experience in medical billing in a health care setting. Knowledge, Skills & Abilities
      • Proficient knowledge base and understanding of department specific billing procedures.
      • Proficiency in accounting and computerized patient accounting systems required.
      • Knowledge of medical terminology. Good communication, analytic, and organizational skills with the ability to clearly explain/ discuss issues on the telephone. Licenses & Certifications
        • None Required. Degrees
          • High School Graduate. What We'd Like to See
            • Ideally would like some background in billing and working with audits, pharmacy knowledge would be a plus.

Keywords: Advocate Christ Medical Center, Sheboygan , Billing Representative I Pharmacy, Accounting, Auditing , Sheboygan, Wisconsin

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