Spherion is assisting our retail pharmacy partner in their search for a Billing Specialist. Our client is committed to providing the best service and patient care to members of the Madison, WI community.
If you are quality-minded, accurate, and have excellent customer service skills, please submit your resume today so you can be an essential part of this dedicated team!
This a temporary role with the potential for permanent hire.
- Provide staff support for claims processing, payer compliance requirements, and related prescription documentation processes
- Verify patient eligibility, prescription benefits, input insurance into the system or look up missing insurance information, and prepare and submit claims to the appropriate party
- Continual audit of patient files and maintenance of 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, and arrange payment arrangements/collection accounts
- Assist patients, caregivers, and related providers in person and over the phone with questions regarding insurance eligibility, coverage, related benefits, and payments
- Process and reconcile third-party reimbursements, EOBs, patient payments, returns, and credits
- Transmit individual credit card payments as needed
- Accurately process returns and appropriately return stock
- Log insurance fees into the system
- Run script management
- Review and run rejection reports and process
- Perform audit research
- Reprocess rejected claims to 3rd party providers by identifying why the claim was rejected and making any necessary corrections
- Complete prior authorization request forms
- Process medication change requests, fax them to facilities, and track outcomes
- Make outgoing calls to insurers, responsible parties, and others to follow up on rejected claims and to obtain accurate insurance information
- Complete other tasks and training as needed
- High school diploma or GED
- Pharmacy Technician license/certification/registration (per state requirements)
- 1+ years of customer service experience
- Excellent computer skills
- Ability to manage tasks in a fast-paced environment and meet deadlines
- Strong, independent problem-solving skills
- Great attention to detail and accuracy
- Quality minded with a dedication to accuracy
- Clear and concise written and verbal communication skills
- Ability to use standard office equipment, sit for long periods of time, and occasionally move objects weighing up to 40 lbs.
- Associate degree
- National Certification (PTCB)
- 1+ of long-term care or retail pharmacy technician or billing experience
- Pharmacy operations system experience
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.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including health, and an incentive and recognition program (all benefits are based on eligibility).
For certain assignments, Covid-19 vaccination and/or testing may be required by Spherion's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Spherion representative for more information.