Full-time

Pharmacy Billing Specialist

Hyderabad, India

Job Description:

  • Must have 1-2 years of relevant experience
  • A pharmacy biller is responsible for handling and transferring patient information, submission of claims to insurance companies, and ensures that the payments for medical services are received in a timely manner.
  • To confirm patient benefits and insurance eligibility.
  • Submits daily claims to insurance companies.
  • Research and establish patient eligibility coverage with insurance providers.
  • Contact insurance providers for issue clarifications.
  • Obtains appropriate files from doctors such as prescriptions, Certificates of Medical Necessities, prior authorizations
  • To follow up on the late payments and initiate late payment notices to relevant team.
  • Uses analytical skills to investigate the issues with unpaid claims and/or denied payments.
  • Interact with insurance companies daily regarding overrides, rejections and insurance updates.
  • Reviews for insurance updates, as needed.
  • Works on medical review, appeals, and reconsideration as needed.
  • Ensures medical compliance by maintaining standards set forth by insurances and HIPAA.

 

Eligibility:

  • Pharma Graduates (B. Pharm / M. Pharm/ PharmD) or candidates with medical/pharmacy billing experience can apply.
  • Willing to work in EST shifts.
  • Should possess excellent verbal and written communication skills.
  • Should be competent enough to use computer systems, software, and calculators.
  • Must be familiar with CPT and the latest coding guidelines.
  • Should be able to maintain patient confidentiality as per the HIPAA.

 

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