SUMMARY
Under general direction, the Billing Coordinator ensures the supervision and directs the billing department operations, and activities of personnel; ensures the efficient and timely billing process that includes Facility Statements, Medicaid of Texas, multiple Third Party PDP’s, processing and submitting Prior Authorizations to their respective party.
Essential Functions
- Responsible for the completion of the billing process that includes Facility Statements, Medicaid of Texas, multiple Third Party PDP’s, Hospice and Medicare B billing.
- Responsible for submitting claims and following up with insurance companies.
- Prepare and submit clean claims to various insurance companies either electronically or by paper.
- Responsible for resolving and working Third Party Rejections; knowledgeable with the use of LTC overrides and submissions.
- Responsible for training and implementing the use of Cover My Meds or desired system to process Prior Authorizations.
- Reconcile third party insurance claims.
- Responsible for EOM reports that include correct billing and reimbursement of all compounds, rebilling of claims billed to Medicare that should have been Hospice.
- Profiling and submitting claims to all our Hospice PBMs.
- Responsible for annual Fraud, Waste and Abuse training and attestations to all Third Parties.
- Responsible for informing nursing homes of their residents needing to change Medicare-D plans due to loss of benchmarked status.
- Conduct self in accordance with SSRX’s employee manual.
- Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Provide professional customer service to all customers.
Qualifications
- Educational/Training Requirements
- High school diploma or graduate equivalent degree (GED)
- One year experience in LTC pharmacy or previous experience in related health care as Billing Manager and/or license technician
Job Type: Full-time
Pay: $20.00 - $22.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Application Question(s):
- Are you willing to reliably commute daily to Round Rock, TX for this job?
License/Certification:
- Texas State Board of Pharmacy Technician License (Required)
Ability to Relocate:
- Round Rock, TX: Relocate before starting work (Required)
Work Location: In person