Description:
Piedmont Athens

OP Pharmacy

Full time Days M-F 8am-430pm

JOB PURPOSE:
The Outpatient Pharmacy Financial Services Rep (FSR) is responsible for billing and collecting patient
accounts for all payers assigned, for preparing and auditing claims and billing documents in accordance
with state and federal regulations, producing clean paper and electronic bills, and collection of accounts
receivable in an accurate and timely manner. The FSR assists with intake support activities including
insurance verification/authorization, follow-up of any necessary documents needed to process referrals,
and referral input into agency information system.

Qualifications:

MINIMUM EDUCATION REQUIRED:
High School graduate or GED.
MINIMUM EXPERIENCE REQUIRED:
Three (3) years of related healthcare revenue cycle or patient access experience preferred.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
N/A.
ADDITIONAL QUALIFICATIONS:
Associates or Bachelors degree from a recognized college or university preferred.
Previous medical billing preferred.

KEY RESPONSIBILITIES:
1. Verifies insurance payer eligibility for patients, and initiates and follow required prior
authorizations and organizes documents for data input and review.
2. Coordinates with various referral sources for the provision of care in conjunction with the
pharmacy.
3. Responsible for verifying various source documents including orders and referral documents for
accuracy and completeness and any data input as required to intake referrals.
4. Contacts resources within the agency and/or outside vendors to resolve billing problems or issues
that impact accuracy or deadlines in the processing of claims or referrals.
5. Makes recommendations to supervisor regarding additional equipment or software, which may
enhance office productivity.
6. Performing additional duties such as scanning incoming documentation into patient chart,
discharge audits, and patient satisfaction surveys.
7. Preparing necessary documentation for incoming insurance audits and legal medical record
requests.
8. Performs support functions as needed, which may include any/all of the following: maintaining or
retrieving files and reports, responding to telephone calls, assisting with special projects and
other healthcare related office functions.
9. Provides backup support with additional functions as required to assure all department
operational needs are met including all functions required to complete claim billing, electronic
reimbursement validation, accounts receiveable, payment posting, end of day Treasury
notifications and patient collection processes.