BrightSpring Health Services 3RD PARTY REVENUE CYCLE ASSOCIATE in TAUNTON, Massachusetts
Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
• Work with third party pharmacy payers, including Medicare Part D, Medicaid, Commercial Insurance, Worker’s Comp, Auto Insurance, and Hospice, to secure payment on electronically approved or manually billed claims• Work with internal and external customers to resolve assigned portfolio of accounts in a timely manner by collecting the balance due or by taking other action, as appropriate• Communicate with payers via the telephone, email or on-line websites to gain claim status information, obtain payment details or obtain documentation to identify claims that may have been recouped due to audit.• Work with internal departments, such as Contracting, Audit, and 3rd Party Plan Administration, to obtain necessary information in order to bill or reconcile open AR.• Work with multiple internal databases and reporting tools (Cloud docs, Cognos, Access, etc.) to research and locate payment, check, or remit information• Report to management any issues that may result in uncollected revenue, including payers that are non-responsive or claims that are not successfully resolved after multiple attempts• Researches unapplied cash and resolves misdirected payments.• Print and key variances or write-off’s for review by Team Lead and management to clear uncollectable revenue per guidelines of Sarbanes Oxley requirements and Signature Compliance guidelines.• May be responsible for rebilling claims either electronically in accordance with NCPDP standards, online through payer specific websites, or manually through Universal Claim Forms or other approved methods for favorable resolution of denied claims or underpayments• Maintain and accurately report all reconciliation activity on monthly aging spreadsheets• Record daily productivity results accurately in the Productivity Database• Properly document all communication and follow up that is necessary to collect reimbursement• Works through assignments independently and timely with limited direction• Able to handle high volume and significant workload• Work with 3rd Party Claims Reconciliation Supervisor and/or Manager on special projects as needed• Performs other related duties as assigned• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
Education/Learning Experience• Required: High School graduate, GED or equivalent experience• Desired: Associates degree, 4 year college or technical degreeWork Experience• Required: 1 year insurance claims reconciliation, Accounts Receivable and/or collections experience• Desired: Third Party Billing or collections/billing experience in the healthcare industry• Desired: AS-400 computer experience, typing skills and Excel Spreadsheet experience• Desired: General understanding of billing requirements for Medicare Part D, Medicaid, and Commercial billing• Desired: Understanding of revenue cycle functions within pharmacy practice or equivalent setting
Skills/Knowledge• Required: Proficiency in MS Office Products (Excel, Word) and basic computer knowledge• Required: Excellent time management skills and attention to detail• Required: Comfortable making phone calls and interacting with internal/external entities• Desired: AS400 Computer Systems Experience
About our Line of Business
PharMerica is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica is one of the nation's largest pharmacy companies. PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about PharMerica, please visit . Follow us on , , and.
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BrightSpring Health Services, and our family of brands, provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact the BrightSpring Disabilities Support Team at 1-833-773-7240 orfor assistance.
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Line of BusinessPharMerica