Pharmacy Billing Specialist (Amber Specialty Pharmacy)
Amber Specialty PharmacyAbout the role
Additional Considerations (if any):
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At Amber Specialty Pharmacy, our commitment to patient care is unmatched. Enjoy fulfillment in a career where you have the opportunity to make a positive impact on patients with complex and chronic conditions.
Monday-Friday (no weekends)
Hours: 7 am - 6 pm CST; varied shifts (to equal 40 hours per week)
Six paid holidays
Must pass post-offer, pre-employment drug background tests as allowed by state, federal, local ordinance, statutes and licensing/accreditation requirements.
Amber Specialty Pharmacy
Job Title: Pharmacy Billing Specialist
Department: Operations
FLSA: Non-Exempt
General Functions
The Pharmacy Billing Specialist ensures accurate insurance information is received and stored. They gather all necessary information to bill electronic NCPDP claims in the appropriate order in the event of multiple payers, review statements to determine accuracy, and navigate financial assistance programs to help patients gain financial support. Communicating with coordinators and co-workers regarding insurance verification and promoting exceptional customer service and professionalism with the community is vital in this position.
The Training Billing Specialist is responsible for boosting the competencies of our employees by developing and conducting effective training documents. Indirectly help enhance the employee’s workplace performance with the Company’s core values. Will be performing the training needs assessment and learning materials for the billing team.
Reporting Relations
Reports to: Lead Pharmacy Billing Specialist
Direct Reports: None
Primary Responsibilities:
Consults with patients to resolve all types of payer and coverage issues.
Contacts the patient, when necessary, to gather insurance and billing information or notify of a delay in processing.
Conducts a benefits investigation, updates patient accounts, prescriptions, etc.
Collects outstanding patient balances.
Processes adjudication rejections, insurance terminations, and insurance changes.
Handles patient benefit statement questions to a conclusion.
Researches and reviews patient inquiries on account balances.
Knows Amber HIPAA policies and maintains patient confidentiality at all times.
Works as a team member with all other departments to verify benefits.
Working knowledge of all necessary computer software to perform job duties.
Bill claims via electronic NCPDP clearinghouse; cross-trains in Medical billing as time allows.
Works claims in the clearinghouse to ensure our payers receive them.
Responsible for aiding in accounts receivable by billing claims correctly and getting them to our payers on time.
Works with team to achieve Company AR goals.
Understanding of payer contracts and how claims should be submitted to each payer.
Has mastered the requirements of a Pharmacy Billing Specia
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