Pharmacy Billing Associate
Overview:
At Synchrony Health Services, we offer collaborative clinical solutions for multiple aspects of senior housing and long-term care including pharmacy, rehabilitation, and lab.
United by our culture of service, we believe in blending compassion with clinical expertise, to the benefit of our partners, our employees, and most importantly, the people we serve.
Synchrony Health Services is an Ancillary division of Trilogy Health Services, which is an award winning company that is leading the way in employee benefits, professional development, personal wellness and recognition.
We invite you to learn more about our unique culture and the exciting opportunities that exist within our organization.
Let's talk about benefits.
Competitive salaries and weekly pay Wage increases EVERY quarter Student loan repayment, scholarships, and tuition reimbursement Health, dental, vision, and life insurance kick in on the first of the month after your start date 401(k) Match Bonuses for attendance, referrals, and gas Quarterly employee recognition ceremonies And so much more!
Responsibilities:
Processes and ensures the accuracy and timely issuance of invoices to customers.
Provides health care professionals with assistance with Medicare, Medicaid, Prescription Drug Plans (PDP's) and Third-Party Insurances.
Duties1.
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 insurers3.
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 party6.
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.
Qualifications:
High School diploma or equivalent.
Licenses/CertificationsKentucky registered pharmacy technician or eligible.
Experience One (1) to three (3) years' billing experience.
Healthcare, senior living industry, pharmacy or long-term care environment preferred.
One (1) to three (3) year's Medicare Part D experience.
Minimum one (1) year multi-facility experience preferred.
Exemplary computer skills that include knowledge of the Microsoft Office Suite of products.
Recommended Skills Billing Claim Processing Ethics Friendliness Health Care Leadership Estimated Salary: $20 to $28 per hour based on qualifications.
At Synchrony Health Services, we offer collaborative clinical solutions for multiple aspects of senior housing and long-term care including pharmacy, rehabilitation, and lab.
United by our culture of service, we believe in blending compassion with clinical expertise, to the benefit of our partners, our employees, and most importantly, the people we serve.
Synchrony Health Services is an Ancillary division of Trilogy Health Services, which is an award winning company that is leading the way in employee benefits, professional development, personal wellness and recognition.
We invite you to learn more about our unique culture and the exciting opportunities that exist within our organization.
Let's talk about benefits.
Competitive salaries and weekly pay Wage increases EVERY quarter Student loan repayment, scholarships, and tuition reimbursement Health, dental, vision, and life insurance kick in on the first of the month after your start date 401(k) Match Bonuses for attendance, referrals, and gas Quarterly employee recognition ceremonies And so much more!
Responsibilities:
Processes and ensures the accuracy and timely issuance of invoices to customers.
Provides health care professionals with assistance with Medicare, Medicaid, Prescription Drug Plans (PDP's) and Third-Party Insurances.
Duties1.
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 insurers3.
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 party6.
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.
Qualifications:
High School diploma or equivalent.
Licenses/CertificationsKentucky registered pharmacy technician or eligible.
Experience One (1) to three (3) years' billing experience.
Healthcare, senior living industry, pharmacy or long-term care environment preferred.
One (1) to three (3) year's Medicare Part D experience.
Minimum one (1) year multi-facility experience preferred.
Exemplary computer skills that include knowledge of the Microsoft Office Suite of products.
Recommended Skills Billing Claim Processing Ethics Friendliness Health Care Leadership Estimated Salary: $20 to $28 per hour based on qualifications.
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