Job Title: Pharmacy Billing Representative - Monroeville, PA (Hybrid)
Job Description:
We are seeking a detail-oriented Pharmacy Billing Representative for our Monroeville, PA location. This hybrid role offers a unique opportunity to work both remotely and onsite, allowing you to balance the flexibility of working from home with the collaborative nature of in-office tasks. As a Pharmacy Billing Representative, you will play a crucial role in managing pharmacy billing processes, ensuring accuracy, and facilitating timely reimbursement for pharmacy services.
Key Responsibilities:
- Accurately process pharmacy billing claims for insurance and other third-party payers.
- Verify and update patient and insurance information in the system to ensure accurate billing.
- Research and resolve billing discrepancies, including identifying rejected or denied claims and taking corrective actions.
- Coordinate with pharmacy teams to ensure billing data is captured correctly.
- Communicate with insurance companies and patients to clarify or appeal denied claims.
- Review insurance policy details and ensure pharmacy services are in compliance with payer requirements.
- Prepare and submit billing statements and claims in compliance with regulatory standards.
- Maintain up-to-date knowledge of insurance and pharmacy billing procedures.
- Track and manage accounts receivable and follow up on outstanding claims.
Requirements:
- High school diploma or equivalent required; Associate’s degree or higher in healthcare, business, or related field preferred.
- Previous experience in pharmacy billing or medical billing is highly desirable.
- Strong attention to detail and ability to handle sensitive patient and billing information.
- Excellent communication skills, both written and verbal.
- Ability to work in a fast-paced environment while maintaining accuracy.
- Proficiency with billing software and Microsoft Office Suite (Excel, Word, Outlook).
- Knowledge of healthcare insurance policies, third-party payers, and regulatory guidelines is a plus.
- Ability to work both independently and in a team environment.
- Ability to adapt to hybrid work requirements: part remote, part onsite.
Benefits:
- Competitive salary based on experience.
- Comprehensive health insurance package (medical, dental, and vision).
- 401(k) plan with company match.
- Paid time off (PTO) and holidays.
- Employee wellness programs and resources.
- Career development and growth opportunities.
- Flexible hybrid work schedule (combination of remote and on-site work).
- Access to employee assistance programs (EAP).
Educational Qualifications:
- High School Diploma or equivalent required.
- Associate’s degree or higher in healthcare, business, or a related field is preferred.
- Pharmacy billing certification (CPhT or similar) is a plus but not required.
Company Overview:
We are a trusted leader in healthcare and pharmacy services, dedicated to improving patient outcomes and delivering exceptional care. As a company, we are committed to fostering a positive and inclusive work environment, where all employees are empowered to grow and contribute. We prioritize innovation, collaboration, and integrity in everything we do. Our mission is to support the health and wellness of our community, and we are excited to welcome a dedicated Pharmacy Billing Representative to join our team.
Equal Opportunity Employer Statement:
We are an Equal Opportunity Employer and value diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, disability, age, or veteran status.
Apply Today:
If you are a detail-oriented individual with experience in pharmacy or medical billing and are looking for a rewarding role in the healthcare industry, we encourage you to apply for the Pharmacy Billing Representative position today! Join our team and make a difference in the lives of our patients and customers.
