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CommuniCare Health Services · 11 hours ago

Pharmacy Billing Specialist

Pharmacy Solutions Group - Indiana

Full-time

Onsite

New Grad, Entry Level

CommuniCare Health Services is currently seeking Pharmacy Billing Specialists to join their Indiana Virginia Pharmacy Solutions Group. The role involves managing billing processes, ensuring accurate and timely billing for assigned homes, and assisting with various auditing and training tasks.

Health CareHealth DiagnosticsHome Health Care

Responsibilities

Completing Action Summary for assigned homes on a daily basis

Census reconciliation on a weekly basis including Medicare. This includes: 1. Verifying correct patient setup for monthly billing (i.e. validating Data set up correctly - MOP’s, Medicare Days, invoice group, customer group, address, allergies, mrn) 2. Completing SQL Reports

Monitor and manage room moves and update in Framework

Begins rebill process based on payer changes

Primary Billing Batches worked in timely manner (2 to 3 days)

Primary and Secondary Rebilling - Private Pay accounts, Medicaid approval, incorrect billing, etc. Communicate to management if Rebilling is not completed by the 9th of each month

Back up for daily deposit

Back up for Hospice Med list and hospice rebilling

Ensure assigned homes billed accurately and timely at month end. (LTC complete by 4th business day. Private pay residents billed by the 5th business day but no later than the 10th of each month.)

Assist Accounts Receivable Analyst in the following: 1. Customer Notes- answer family billing questions for assigned homes in timely manner. 2. Monitor Medicaid Pending Group each month ensuring claims are rebilled once Medicaid approval is received. 3. Send BAE on Medicaid Approved Residents when needed

Third Party Audits as requested by supervisor

Assist with Training and QA (Quality Assurance)

Running Daily MOP Verification Reports (Outside MEDA, MCR Changed to GUAR, Outside MCR Days, Posted MOP Report)

Monthly Composite Batches

Assist with other projects as assigned