PeopleCaddie: Job Apply

Job Description:

Third Party Billing & Collections Associate needed for our client located in Brockton, MA.

Job description and requirements for Third Party Billing and Collections Associate needed:

Ensure maximum reimbursement by resolving payer rejected claims with critical deadlines while adhering to compliance standards and mitigating financial risk to PharMerica and our customers in a high volume, fast paced environment.

Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to PharMerica and their customers.

Research, analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines.

Ensure approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement.

Contact providers and/or customers as necessary to obtain additional information.

Monitor and resolve at risk revenue associated with payer set up, billing, rebilling and reversal processes.

Work as a team to identify, document, communicate and resolve payer/billing trends and issues

Timely complete, communicate and submit necessary payer paperwork including but not limited to prior authorizations forms and manual billing.

Review and work convert billing exception reports to ensure claims are billed to accurate financial plans.

Complete billing transactions for non standard order entry situations as required.

Support training needs

Prepares and maintains reports and records for processing.

Performs other tasks as assigned.

Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

High School Diploma or GED

Associate’s or Bachelor’s degree

Customer Service

Up to one year of related experience.

Pharmacy Technician experience.

Ability to retain a large amount of information and apply that knowledge to related situations.

Ability to work in a fast paced environment.

Basic math aptitude.
Microsoft Office Suite

Knowledge of the insurance industry’s trends, directions, major issues, regulatory considerations and trendsetters.

Pharmacy technician experience

Analytical and problem solving

#PCFA, #Pharma

Billing Analyst

Job ID:

Pay rate range:

City:

State:

Duration:

Job Type:

Job Description:

CONTRACTORS

Find Exclusive Contracting Opportunities

Billing Analyst

Job ID:

Pay rate range:

City:

State:

Duration:

Job Type:

Job Description:

Add Performance Rater (for Prior Role)

CONTRACTORS

Find Exclusive Contracting Opportunities

Contractor Sign Up

Log In

Request a client demo

Hi, .

Client Registration Request

Thank you for registering with PeopleCaddie!

An activation email has been sent to your email address containing your temporary password and a convenient link to PeopleCaddie’s Client Portal. Just log in and begin creating job orders!

Thank you for registering.

Start by filling out your profile.

Forgot Password?

Please Check Your Email

If is associated with a PeopleCaddie account, you should receive an email message shortly containing instructions on how to create a new password.

Didn't Receive the Email?

Check your spam or bulk folders for an email coming from [email protected]

Thank you for registering
with PeopleCaddie!