POSTED June 21

Billing Verification Specialist - Remote - Work From Home at Healthe systems

  • Data Entry
  • Fulltime
  • Anywhere (100% Remote) Only
Job Description

Indeed's salary guide

  • Not provided by employer
  • $22K - $27.8K a year is Indeed's estimated salary for this role in Remote.

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EASTERN TIME ZONE APPLICANTS ONLY AT THIS TIME IN EITHER: FL/GA/NC/SC/PA/VA/MD/OH/TN

WORK FROM HOME REQUIREMENTS: To facilitate working from home, and as a requirement for this role, candidates must provide their own reliable, high speed internet access with sufficient bandwidth to execute all job functions. Additionally, candidates must provide a private workspace free from distraction and noise. Company laptop will be provided.

Summary: Processes pharmacy medical bill exceptions and handles outbound telephone calls to our pharmacy partners in order to provide exceptional service for our customers. In all tasks, follows departmental guidelines and procedures as required and in accordance to state bill processing requirements.

Key Responsibilities: “To simplify complexities for each customer.”

  • Contacts pharmacies via telephone and converts pharmacies or point of sale transactions to online bill processing.
  • Reviews and processes paper bills via internal website in an accurate manner and according to departmental procedures.
  • Handles and maintains email and other queues to allow processing of paper bills.
  • Creates prior authorizations approving or denying medications or doctors as requested per clients.
  • Ensures that turnaround times are met for assigned task and queues.
  • May handle mail task, as assigned by management.

Qualifications/Education/Certifications:

High school diploma or general education degree (GED); or equivalent combination of education and experience required. Prior related experience preferred.

Knowledge, Skills and Abilities:

  • Requires the ability to work in a Windows environment and to utilize the keyboard and mouse to swiftly enter data into the system.
  • Requires ability to prioritize and adapt to change, including reprioritizing throughout the day.
  • Prefer (not required) experience in any of the following areas:
    • Medical bill review experience and/or billing form experience (HCFA 1500, NCPDP, HCFA/DWC-9, DWC-66 & DWC-10).
    • Experience in workers’ compensation bill review
    • Familiarity with pharmacy providers
    • One year of prior customer service experience, with telephone customer service experience preferred.
    • Prior related experience
  • Prefer basic familiarity with Microsoft Outlook and Microsoft Teams

Physical Demands/Working Conditions:

Duties are performed primarily in a home office setting utilizing computer equipment. Travel to attend meetings and visit locations throughout the country may be required. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is frequently required to use hands. The employee is occasionally required to stand and walk.*** Job descriptions will be reviewed and are subject to changes of business necessity. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

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