Pharmacy Billing and Reporting Specialist (WFH)

Pittsburgh, Pennsylvania

Industry: Hospital

Salary: Competitive

Job type: Full-Time

The Pharmacy Informatics department is looking for a Pharmacy Billing and Reporting Specialist to join their team at UPMC Presbyterian. As a Pharmacy Billing and Reporting Specialist, you will enter charges for patient medications based on documented records in the Electronic Medical Record. You will also review several reports daily to reconcile patient charges. This role involves collaborating closely with the Revenue Cycle team to ensure claims are promptly paid through both reviewing and addressing claim denials to secure correct reimbursement.

This position will allow you to work from home after training! You will be able to enjoy working flexible daylight hours with one, 8-hour shift every other weekend.

Responsibilities:

Run pharmacy system interface error reports, reviews and corrects all errors.
Assist with identification of problems related to the department and reporting such to the Manager of Billing with a proposed solution in a timely fashion. Identify or inform the Supervisor/Production Unit Manager of issues or problems associated with non-payment of claim.
Participate in review and evaluation of claim denials to ensure appropriate reimbursement.
Work with the payors and subscribers to resolve issues and facilitate prompt payment of claims.
Verifies and tests changes entered by Pharmacy IT staff.
Participate in assessing claim edits to enhance the billing system functionality and identify user training and development needs.
Performs system maintenance in various pharmacy information systems. Updates pricing data, verifies that pricing calculates correctly, that correct transaction code is assigned, and all adjustments are correctly documented.
Verifies and adds new users of the systems, maintains documentation and troubleshoots user access problems.
Assess and monitor workflow volumes on an ongoing basis during the growth and development of the billing department to ensure optimal performance of staff.

Qualifications:

High school diploma or equivalent.
2 years of prior work experience in physician billing, as well as experience in third party payors.
2 years of experience as a Pharmacy Billing Specialist which includes training in updating codes in the pharmacy information system.
Knowledge of medical terminology, CPT codes and diagnosis codes.
Good computer skills, including spreadsheet application and word processing.
Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Created: 2024-09-05

Reference: 6181862551

Country: United States

State: Pennsylvania

City: Pittsburgh

ZIP: 15216