CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

Responsibilities

Manage all fiscal functions necessary to ensure the prompt and correct payment of all monies owed by both insurers and patients.

Answer billing and insurance inquiries on patient accounts from patients, insurance companies and other departments. Create and maintain Excel spreadsheets to report daily, weekly or monthly activity of cash, billing and collection status. Identify and document overdue patient accounts to be sent to collections.

Identify and post cash to correct patient accounts. All unidentified cash is resolved in a timely manner. " Knowledgeable and responsible for multiple payers.

Mail private pay statements to patients and perform necessary follow-up and investigative work as required. Maintain daily cash transactions for bad debt.

Maintain, correct, and reconcile batch posting for any or all payers as requested by the Supervisor.

Monitor top 10 high dollar accounts per financial class as assigned.

Post, reconcile, mail, and file all refunds that are created.

Prepare adjustments that are necessary to change existing accounts receivable to update patient information.

Review billing edit report to identify and perform data edits needed to ensure that claims are submitted to the correct payer and that all required information is included.

Review unpaid accounts by examining remittance advice and aging reports for overpayments and refunds. Investigate and take action on unpaid accounts to bring them to closure.

Submit claims to appropriate insurance carriers or organizations to obtain payment for services provided.

Utilize billing software lo confirm orders for billing.

Assist all front line workers with questions/issues.

Primary trainer for all new employees and any existing employees who are learning a new function.

Assist Supervisor and Manager with making sure all current priorities and initiatives are being followed.

Skills & Abilities

Strong customer service and interpersonal skills

Effective written and verbal communication

Excellent organization, problem solving skills and attention to detail

Meet the quality assurance and benchmark standards set by the management team

Knowledge of patient accounting systems, third party billing and collections guidelines

Ability to communicate with patients, payers and outside agencies through telephone, electronic and written correspondence

Requirements

Associate degree preferred.

Collections or medically billing experience with an understanding of ICD9, CPT4, HCPCS and medical terminology is preferred

Familiarity with third party payer guidelines, reimbursement practices and available financial resources is preferred

Proficiency in the Microsoft Suite

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.