Pharmacy Billing Specialist

Madison, Wisconsin
Administrative & Support Services (Office and Administrative Support Occupations)
Job Type
Temp to Perm
Working Hours
8:30 AM - 6:30 PM
US$ 15.00 - US$ 17.00 per hour
Ref. Number
Moto Gladys Igahara, Spherion
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Job Description

The Billing Specialist is responsible for processing claims to insurance companies, supporting both long term care locations in Madison and Menomonee Falls, and all billing related processes and providing excellent customer service and care to patients, caregivers, and medical providers.

- Provide pharmacy staff support for claims processing (electronically or with HCFA 1500 form), payer compliance requirements and related prescription documentation processes including prior authorizations
- Verify patient eligibility, prescription benefits, input insurance into the system or look up missing insurance information and preparation and submission of claims to insurance companies; commercial, Medicare, Medicaid and other third-party payers
- Continually audit patient files and maintain corresponding documentation necessary to defend third party audits and maintain payer and company compliance
- Review and prepare facility and patient statements monthly, review reimbursement reports, pursue payment from delinquent accounts, arrange payment arrangements and collection accounts
- Assist patients, caregivers, and related providers with questions regarding insurance eligibility, coverage, related benefits, and payments
- Process and reconcile third party reimbursements, EOBs, patient payments, returns, and credits
- Process returns and appropriately return stock to ensure accuracy
- Logging insurance fees into the system
- Run script management (ICD-10 codes)
- Review and run rejection reports and process accordingly
- Audit research
- Answer phone calls related to billing questions
- Other essential functions and duties may be assigned as needed

Working hours: 8:30 AM - 6:30 PM

- Advanced computer skills; pharmacy operations system experience preferred/required
- Ability to work independently and deliver to deadlines
- Ability to solve problems with minimal direction
- Great attention to detail and accuracy
- Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines
- Quality minded; motivated to seek out errors and inquire when something appears inaccurate

High School

1-4 years

- 1+ years of customer service experience required
- Long term care or retail pharmacy technician or billing experience preferred

Apply Today!

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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