Medical Billing Specialist
HealthCare Reserves, a division of The Reserves Network, is a leading provider of staffing services in Allied Health, Nursing, and Medical Office staff. Our core business consists of flexible staffing services, including Temporary, Temp-to-Hire and Direct Hire placements.
Healthcare Reserves has partnered up with a Pharmacy in the Medina/Akron Ohio area and we are currently seeking a Medical Billing Specialist for a immediate temporary to possible permanent position.
- Monitor and resolve rejected claims appearing on pharmacy system.
- Become familiar with each pharmacy’s policies and procedures regarding claims management.
- Submit insurance claims and billing to proper insurance company for payment
- Knowledge of third party policies and NCPDP standard for claim submission.
- Communicates with other departments on claim related matters.
- Complies and enforces all company and departmental policies and procedures.
- Complies with all applicable state and federal regulations related to pharmacy and claim billing practices.
- Responsible with achieving department goals in volume, production, quality, customer service.
- Direct claims to other departments for resolution as deemed necessary
- Identify trending by recognizing problem areas for pharmacies that may reduce rejections when corrected.
- Assist with daily and month-end billing
- Any Medical A/R and collections
- High school diploma or GED equivalent. Proficient in Microsoft Office required, general knowledge and understanding of third party claim submission
- Minimum of two years medical billing or third party claim submission and adjudication desired. Along with Prior authorizations experience
- Previous LTC Retail or Mail order pharmacy billing preferred.
- Previous Medical Billing experience
- Must be able to communicate effectively both verbally and in writing. Individual must have a strong internal and external customer service focus, and work as a team player.
- Brightree Experience preferred but will train.
Knowledge Skills and Abilities
- Ability to read, analyze, and interpret general business periodical, professional journals, technical procedures, or government regulations
- Ability to write general communications
- Ability to effectively present information and respond to questions from groups of manager, clients, customers and general public
Essential Physical Requirements
- The physical demand described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
- Wile performing the duties of this job, the employee is frequently required to sit; use hands, fingers to feel, talk and hear. The employee is occasionally required to stand and walk. The employee must occasionally lift/move up to 50 pounds.
- Hospital Environment
- Office Environment
- Work Hours expected – 8:30-5PM Monday – Friday
About Healthcare Reserves
Healthcare Reserves exists to be different, as it is easy to be the same as other staffing providers in our space. We aim to foster a collaborative work environment where people have the freedom to be creative, to put their ideas on paper, and most importantly, to execute – in other words, don’t hold back from being a “thought-leader”, regardless of position, if that’s what it takes to be the motivated and energetic person our healthcare professionals and customers deserve. We strive to place quality people in a position they are right for – we take the time to listen, to understand and discover what our team members and customers truly want and need in order for them to say “yes”!