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Pharmacy Billing Associate
Job description
Job Duties:
1. Runs daily ECS log report to identify denied claims for Medicare or other insurers.
2. Reviews and completes all denied claims in the ECS log for Medicare and other insurers
3. Requests prior authorization on drugs that are denied for prior authorization.
4. Obtains third-party insurance information on all necessary orders.
5. Bills any non-covered drugs to the appropriate party
6. Enters debit/credit adjustments in Framework as needed. Complete the Framework Adjustment Form and forward a copy to the Accounting Department.
7. Ensures patient profiles are updated with payor changes and exceptions.
8. Notifies facilities of changes and exceptions when appropriate.
9. Processes and prints all monthly facility invoices.
10. Assists with special projects as needed.
11. Meets Expectations of Excellence for position.
12. Supports location, departmental goals, and the overall objectives of the Company.
13. Complies with all laws, regulations and standards of ethical conduct.
14. Responsible for uncompromising levels of cleanliness and safety.
15. Leads by Example (LBE), upholds and promotes the culture, mission and values of the Company.
16. Performs all job duties with a friendly positive and team-oriented approach.
17. Maintains professional/technical competencies and proficiencies for job responsibilities.
18. Complies with all Company policies, procedures, rules and standards.
2. Reviews and completes all denied claims in the ECS log for Medicare and other insurers
3. Requests prior authorization on drugs that are denied for prior authorization.
4. Obtains third-party insurance information on all necessary orders.
5. Bills any non-covered drugs to the appropriate party
6. Enters debit/credit adjustments in Framework as needed. Complete the Framework Adjustment Form and forward a copy to the Accounting Department.
7. Ensures patient profiles are updated with payor changes and exceptions.
8. Notifies facilities of changes and exceptions when appropriate.
9. Processes and prints all monthly facility invoices.
10. Assists with special projects as needed.
11. Meets Expectations of Excellence for position.
12. Supports location, departmental goals, and the overall objectives of the Company.
13. Complies with all laws, regulations and standards of ethical conduct.
14. Responsible for uncompromising levels of cleanliness and safety.
15. Leads by Example (LBE), upholds and promotes the culture, mission and values of the Company.
16. Performs all job duties with a friendly positive and team-oriented approach.
17. Maintains professional/technical competencies and proficiencies for job responsibilities.
18. Complies with all Company policies, procedures, rules and standards.
Schedule:
There are two shifts available, one that is 2pm-10:30pm Monday-Friday with no weekends (and a 5% shift differential). The other shift available is 11am-7pm Monday-Friday with rotating weekends (time for weekends is based on needs - can be fluctuating but does provide overtime).
**This position does require Covid-19 vaccination. However, we do accept religous and medical exemptions.**
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