Billing Specialist Sr - BioPlus Specialty Pharmacy
Elevance Health

Job Info

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Be Part of an Extraordinary Team

BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that's easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer's treatment journey.

Title: Billing Specialist Sr

Location: Hybrid position, will work 2-3 days onsite at 376 Northlake Blvd. Altamonte Springs, FL 32701.

Candidates must reside within 50 miles or 1-hour commute each way of 376 Northlake Blvd. Altamonte Springs, FL 32701.

Shift: Day Shift

Build the Possibilities. Make an Extraordinary Impact.

The Billing Specialist Sr is responsible for assembling and maintaining all necessary documentation for billing purposes.

How you will make an impact:

Primary duties may include, but are not limited to:

• Communicates with Revenue Cycle teams, payors and others to resolve account problems; participate in meetings as needed to address payor concerns.
• Evaluates the payment status of outstanding third-party claims and resolve impediments to payment by providing information to internal and external stakeholders.
• Completes work on special projects, queries and reports as assigned.
• Maintains billing system database; identifies, analyzes and reconciles discrepancies in data; posts to sub ledgers; coordinates account eligibility with Membership areas; and provides billing information to internal and external contacts; and first line collections.
• Professional and timely oral or written communication to internal and external customers.
• Fully proficient with daily tasks and is able to handle more complex billing situations with minimal guidance and provide recommendations for decision making.

Minimum Requirements:

Requires H.S. diploma or equivalent and minimum of 3 years billing and collections experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• AS in accounting preferred.
• In-depth understanding of Pharmacy billing policies and procedures including NCPDP D.0 standards preferred.
• Proficiency in spreadsheet and database software preferred.
• Advanced analytic ability preferred.
• Ability to make good judgments in demanding situations preferred.
• Effective communication skills preferred.
• Ability to logically and accurately organize details preferred.
• Ability to manage multiple tasks with ease and efficiency preferred.
• Ability to work independently and be result oriented preferred.
• Positive, can-do attitude coupled with a sense of urgency preferred.
• Effective interpersonal skills, including the ability to promote teamwork preferred.
• Ability to ensure a high level of customer satisfaction preferred.
• Ability to use various computer applications including EnterpriseRx, Microsoft Office, etc. preferred.
• Knowledge of medical and insurance terminology, CPT, ICD coding structures, and billing forms (UCF, 1500) preferred.
• Ability to maintain confidentiality of sensitive information preferred.

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