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.