Pharmacy Billing Specialist with 14 years of long term care Pharmacy and retail pharmacy experience. Self-starter with extensive knowledge of Medicaid and Medicare procedures. Excellent data entry skills and telephone etiquette. Detail-oriented and focused on accuracy and efficiency.Team player with strong commitment to client services• Energetic/outgoing/aggressive/relentless patient advocate.
•Customer Service/Customer Relations
Expert organizational and management skills
Verified that information in the computer system was up-to-date and accurate.
Created monthly reports for records, closed terminated records and completed chart audits.
Organized billing and invoice data and prepared accounts receivable and expected revenue reports for controllers.
Identified and resolved system and account issues.
Updated departmental standard operating procedures and database to accurately reflect the current practices.
Identify and resolve patient billing complaints.Perform various collection actions including contacting patients by phone,
correcting and resubmitting claims to third party payers.•Reviewed private pay billing statements for correctness and accuracy of charges.
•Worked with residents, patients, facilities, and family members regarding charges, complaints, and collection activities
•Review facility unbilled charges for correctness and accuracy of charges.
•Respond to written customer inquiries regarding account status within forty-eight (48) hours. Research customer's account and document follow-up appropriately.
Prior authorizations,insurance audits.
Ordered and maintain all pharmacy supplies. Communicate and troubleshoot problems that interfere with the payment of claims.
Communicate with physicians,nurses and insurance companies.Responsibilities include insuring the accurate and timely dispensing and shipping of all related prescriptions• Identify and enroll all patients in appropriate patient assistance programsData entry Related Duties:• Process faxes and E-script orders• Manage and process refills.
Input demographic and insurance information• Verify eligibility and specific drug coverage• Work on prior authorizations and insurance over-rides.Precisely processed third party prescriptions and managed adjudication review.Processed up to 400 prescriptions on high volume days with 100% accuracy.
Maintained updated records such as pharmacy files, patient profiles, charge system files, inventories and controlled drug registries.
Entered new patient profiles and prescriptions into medication input software system.Communicated directly with doctors' offices via telephone, fax and email.
Provided friendly customer service at prescription drop-off and pick-up counters.Worked closely with pharmacists and used medication input software to safely and accurately dispense medication.Efficiently answered multi-line phone and processed high volume of order requests from nurses, doctors and pharmacists.Verified patient data and billing information.
Framework and docu-track software knowledge .
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