Billing/Adjustment Specialist I

Client max bill rate ***
Supplier max bill rate ***
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Add city / state at the top of the resume. They must be within 1 hour from the Monroeville location.

As a Biller/Adjustment Specialist, you will ensure timely and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. You will review requests for claim reconciliation and process appropriate adjustments.

* Minimum 1 year experience performing healthcare reimbursement, pharmacy insurance/billing or related work.* Ability to prioritize daily tasks. * Working knowledge of medical terminology. * Customer service skills with the ability to work in a team environment. * Experience in MS Word, Excel and Outlook.


Must live within 1 hour of Monroeville site, Required to come in the office Tuesdays and Thursdays (every other week) for a total of 4x a month, but Willing to come onsite for business needs if that changes.

Position Summary:

As a Biller/Adjustment Specialist, you will ensure timely and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. You will review requests for claim reconciliation and process appropriate adjustments. As part of the billing and reimbursement team, you will work in a fast paced and team focused environment to ensure timely and accurate billing to insurance providers. Located in the Monroeville Facility, this opportunity also provides free parking. We will support you by offering all the tools and resources you need to be successful in a collaborative team-based environment.

Duties:

What you will do
Third party insurance claim billing associated with the dispensing medication and using the bill method required by the payer.
Transmit or submit claims (paper/electronic) to insurance payors for reimbursement.
Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
Maintain supporting and chronological notes that detail action taken to resolve billing edits.
Maintain patient demographic and insurance information and data collections systems, including all billing reports, work queues, or diversions according to payer and company policy guidelines.
Research and respond to insurance companies and governmental payors regarding billing issues or related questions by telephone, via the internet, and in writing.
Contact patients, physician's offices or insurance carriers as needed in order to expedite billing claims.
Process adjustments based information provided in work queues or requests submitted through other areas in the organization.

Experience:

Required Qualifications
1 year of Healthcare Insurance Billing or related experience.
Experience using Microsoft Office products specifically Excel, Outlook and Word.
Must live within a 1 hour commute from Monroeville, PA.

Preferred Qualifications
Insurance billing or collections experience.
Customer service in a healthcare environment.
Experience working in a healthcare reimbursement system.
Effective customer service skills and experience that shows ability to work in a team environment.
Attention to detail.
Ability to utilize analytical skills.
Ability to communicate with clientele in a professional manner

Education:

Verifiable High School diploma or GED is required.