Director of Purchasing and Inventory

MedWiz of Kentucky LLC • Lexington, KY

1d • Onsite

About The Position

The Billing Collections Specialist in a pharmacy plays a crucial role in ensuring the accurate and timely collection of payments from insurance companies, patients, and other third-party payers. This position requires strong attention to detail, excellent communication skills, and a solid understanding of insurance billing processes and regulations. The primary responsibility of a Billing Collections Specialist is to maximize revenue by minimizing outstanding balances and resolving billing discrepancies.

Requirements

• High school diploma or equivalent (some employers may require an associate's or bachelor's degree).
• Previous experience in medical or pharmacy billing, collections, or healthcare finance preferred.
• Knowledge of insurance billing processes, reimbursement policies, and medical coding systems (e.g., CPT, ICD-10).
• Familiarity with pharmacy claims processing software and electronic health records (EHR) systems.
• Strong understanding of insurance regulations, including Medicare and Medicaid guidelines.
• Excellent communication and interpersonal skills for effective interaction with patients, healthcare providers, and insurance representatives.
• Attention to detail and accuracy in data entry, record-keeping, and financial reporting.
• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
• Proficiency in using office software (e.g., Microsoft Excel, Word) and billing software applications.

Responsibilities

• Billing and Claims Processing:
• - Generate and submit accurate insurance claims to various payers, including private insurance companies, Medicare, and Medicaid.
• - Verify patient insurance coverage, benefits, and eligibility.
• - Review claims for accuracy, completeness, and compliance with insurance requirements and pharmacy policies.
• - Resolve claim rejections, denials, and other billing errors.
• - Follow up with insurance companies to ensure prompt payment of outstanding claims.
• Collections and Payment Posting:
• - Monitor and manage outstanding accounts receivable.
• - Contact patients, insurance companies, and other third-party payers to collect overdue payments.
• - Negotiate payment arrangements and develop repayment plans, when necessary.
• - Post payments accurately to patient accounts and reconcile discrepancies.
• - Investigate and resolve billing discrepancies and disputes.
• Customer Service:
• - Provide excellent customer service to patients, healthcare providers, and insurance representatives.
• - Respond to inquiries regarding billing and insurance claims status.
• - Address patient concerns and assist in resolving billing-related issues.
• Compliance and Documentation:
• - Maintain patient confidentiality and adhere to HIPAA regulations.
• - Ensure compliance with federal and state laws and regulations related to billing and collections.
• - Document all communication and activities related to billing and collections accurately and thoroughly.
• Financial Reporting:
• - Prepare and analyze reports related to accounts receivable, collections, and aging of outstanding balances.
• - Identify trends and areas for improvement in billing and collections processes.
• - Provide regular updates and reports to the pharmacy management team.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED