LTC Pharmacy Billing Specialist – Adjudication

  • Forum Extended Care Services
  • 4201 West Victoria Street
  • Posted: Nov 30, 2018
Allied Health

Job Description

Forum Extended Care Services is a fast-paced, independent institutional pharmacy providing unmatched dispensing and consulting services to long-term care communities in Illinois, Wisconsin, and Indiana. We are currently seeking bright, resourceful candidates to join our team of 180+ dedicated professionals in a state-of-the-art, innovative environment. Celebrating our 50th anniversary, we have a customer-oriented, high-performance culture that emphasizes quality improvement, idea sharing, and goal attainment to ensure the highest quality of care for our patients.:

Position Overview:

This position primarily involves ensuring the timely and appropriate processing of drug, DME, and other supplies as ordered by facilities. This position is part of a team that is responsible for account reconciliation, research and collection for third party pharmacy accounts receivables on assigned divisions.

Reports To:

Lead Billing Specialist | Assistant Billing Manager | Billing Manager

Job Functions:

* Responsible for billing private insurances, private individuals and/or Government entities for medications and medical/DME supplies.
* Responsibilities include billing, collection, account follow-up and compliance with all governmental and regulatory agencies.
* Understand and comply billing regulations/policies including but not limited to Medicare and Medicaid programs.
* Follow-up with payers, patients and other appropriate parties to collect open billings in a timely manner and to ensure compliance with billing regulations.
* Coordinate all patient information and process paperwork accurately including preparation of file for billing.
Requirements:

* Skills: Basic MS Excel, Word and 10-key skills required.
* Ability to file, perform accounting functions, maintain records, understanding of reimbursement requirements, good typing and telemarketing skills.
* Two years of pharmacy, insurance office, doctor’s office or three years general office experience.
* General knowledge of government, regulatory and company billing and compliance regulations/policies for Medicare, Medicaid, preferred.
* Knowledgeable in all major insurance carrier reimbursement guidelines and eligibility for coverage by third party payers.

2 OPEN POSITIONS::

1.) 2ND SHIFT: 3:30PM - 11:30PM | MONDAY - FRIDAY | EVERY OTHER WEEKEND | MINIMUM 1 HOLIDAY PER YEAR:

2.) OVERNIGHTS: 11PM - 7:30AM | FRIDAY - TUESDAY | MINIMUM 1 HOLIDAY PER YEAR:

MUST BE A LICENSE CERTIFIED (OR GRANDFATHERED IN) PHARMACY TECHNICIAN: