Pharmacy Business Office Specialist

Overview

This position prepares, verifies, corrects, and submits electronic insurance claims, resolves complex billing issues, codes, and posts entries into Pharmacy patient accounting system to ensure accurate and expedient processing of general accounting, accounts payable, accounts receivable or other financial documentation. The position may require performance or supervision of clerical, receptionist or other business office related tasks.

• 16750 Westgrove Dr, Addison, TX 75001 Suite 100

• 11am-7:30pm

• 2 years of experience in billing, collections, pharmacy billing, or physician billing; insurance background preferred
• Long‑term care pharmacy experience preferred
• Experience with electronic claims systems or patient accounting software
• Familiarity with Medicare, Medicaid, and commercial insurance billing guidelines
• Strong computer literacy
• Ability to handle multiple tasks and remain effective in potentially stressful situations
• Ability to read, write, and speak English clearly is required
• Srong organizational, problem-solving and computer skills.
• Must possess good written and verbal communication skills for interfacing with all levels of staff, physicians, patients and other contacts.

• Ensures patients are registered in Pharmacy patient accounting system and billed with appropriate payor type.
• Reviews claims for accuracy, performs required edits, submits claims and rebills to payors daily in electronic format to ensure accurate and timely filing of claims and prompt payment.
• Requests additional information from patients, insurance carriers, Pharmacy staff, and other Cantex departments to make corrections to claims.
• Receives and posts assigned payment batches to the appropriate patient account or facility account from checks or remittance advice using the appropriate payment/adjustment code to ensure accurate and timely posting of receipts
• Makes appropriate corrections such as changing payor types, updating payor information, and/or changing the priority of the payor accounts to ensure payments are posted accurately.
• Accumulates and provides data/documents for maintenance of accounts payable, accounts receivable and payroll ledgers.
• Prepares and delivers bank deposits.
• Compiles data and provides cumulative reports on a daily, weekly, or monthly basis as required by departmental Supervisor, Manager and/or Director of Pharmacy.
• Answer incoming calls in a timely manager.
• Maintains appropriate inventories of various office supplies and forms.
• Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact billing, collections, and payors.
• Adheres to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.
• Actively participates in Business Office or Pharmacy meetings.
• Seeks advice and guidance as necessary to ensure proper understanding.
• Responsible for assuring patient/resident safety.
• Performs other duties and tasks as assigned.

The essential functions described above are representative of those an employee encounters while performing the basic functions of the position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. While every effort has been made to identify the essential functions of the position, it in no way states or implies that these are the only duties you will be required to perform.

The Business Office Specialist is at a minimum responsible for the above functions, either directly or through delegation to qualified staff.

We are an Equal opportunity employer;
We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.

Diversity, Equity, and Inclusion are at the heart of Cantex. We are committed to a culture that respects our differences and values the contributions of all people.

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