Mountain Area Health Education Center - MAHEC · 3 months ago
Revenue Cycle Pharmacy Billing Specialist
Westridge - Asheville
Full-time
Onsite
Entry Level
$22.31/hr - $22.31/hr
1+ years expMountain Area Health Education Center (MAHEC) is looking for a Revenue Cycle Pharmacy Billing Specialist to manage billing processes related to pharmacy benefit claims. The role involves ensuring accurate claim submissions, resolving billing issues, and maintaining compliance with healthcare regulations.
Health CareHospitalMedical
Responsibilities
Ensures invoices are created appropriately based on the payer type for the assigned payer
Ensures that the appropriate authorization and diagnosis are obtained for the claim
Prepares and submits clean claims to various insurance companies via pharmacy benefit manager (PBM)
Resolves rejected adjudicated claims based on denial reason
Generates “clean” claims on a consistent basis
Maintains a thorough understanding of NDC (National Drug Code) numbers
Ability to convert drug dosages into appropriate billing units per HCPC
Shares knowledge gained with other staff members and works as a team member
Interacts with others in a positive, respectful, and considerate manner
Acts as the liaison with necessary affiliated departments to ensure 340B Program integrity
Handle collections and follow up on outstanding accounts
Responsible for managing and troubleshooting pharmacy billing issues and ensuring that adequate systems checks are reviewed to prevent billing issues
Performs other job-related duties as assigned
Recognizes patients’ rights and responsibilities and supports them in the performance of job duties, respects patient’s rights to privacy and confidentiality
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations
Performs other job-related duties as assigned
Qualification
Required
High School Graduate or equivalent
1 year experience within a pharmacy environment working with EOB/RAs and reconciliation of outstanding payments
Knowledge of NDC numbers
Knowledge of billing practices related to billing and collection activities related to pharmacy benefit claims
Ability to convert drug dosages into appropriate billing units per HCPC
Excellent skills in Microsoft Office including Word, Excel, PowerPoint, and database applications
Preferred
Working with pharmacy payment software such as Provider Pay
Benefits
Total Rewards (pay + benefits)
Company
Mountain Area Health Education Center - MAHEC
The Mountain Area Health Education Center (MAHEC) is a leader in healthcare practice, education, innovation and research.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
William R. Hathaway, MD, FACC
Chief Executive Officer
Zach Levin
Chief Financial Officer
Company data provided by crunchbase