Pharmacy Billing Specialist

Job Description

We are seeking a motivated and detail-oriented Pharmacy Billing Specialist to join our team! The ideal candidate will have a strong background in medical billing, excellent organizational skills, and a commitment to providing superior support in pharmacy claim handling and insurance billing. Must be local to Indianapolis.

Hours: Monday - Friday 8am - 5pm

Responsibilities for the position include the following:

Provide assistance in preparing and submitting pharmacy claims to third-party insurance carriers as needed.

Secure and verify all necessary medical documentation required by third-party insurance carriers for claims processing.

Conduct follow-ups with third-party insurance carriers and patients to address unpaid claims or balances and resolve discrepancies.

Research and analyze payer regulations and claim guidelines, ensuring compliant billing practices by leveraging payer-specific tools and resources.

Verify insurance coverage for pharmacy services prior to rendering services, when applicable.

Re-validate benefit coverage criteria during claim follow-up processes.

Maintain accurate and thorough documentation of all steps taken to resolve claim-related issues within billing software systems.

Regularly report claim trends and issues to the Team Lead and/or Billing Manager.

Collaborate with the Team Lead and/or Billing Manager to establish and achieve short-term and long-term goals while providing progress updates.

Relevant experience in pharmacy or medical billing.

Strong understanding of insurance payer guidelines and regulations.

Proficiency in using billing software and associated tools.

Excellent communication and problem-solving skills.

Attention to detail and ability to multi-task efficiently.

High School Diploma or equivalent

3 years related experience

Software: Athena - EMR; ScriptMed