Address
Form of workPharMerica
OverviewJoin our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!
We offer:
DailyPay
Flexible schedules
Competitive pay
Shift differential
Health, dental, vision and life insurance benefits
Company paid STD and LTD
Tuition Assistance
Employee Discount Program
401k
Paid-time off
Tuition reimbursement
Non-retail/Closed-door environment
Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
The primary function of this role is to research and reconcile unapplied cash payments to open Accounts Receivable at the claim level. This may include applying payments, re-directing payments to other financial areas, or coding claims for refund. The associate will be required to follow all allocation and reconciliation of unapplied cash funds in accordance with PharMerica's Cash Processing Center's Policy and Procedures and the Consumer Credit Protection Act of 1977.
Responsibilities- Researches and takes necessary actions to resolve unapplied cash portfolio
- Determine if payments should be re-applied to claims or refunded to payer
- Reconciles payments to open AR at claim level
- Work with multiple internal databases and reporting tools (Cloud docs, Cognos, Access, etc.) to research and locate backup information to be sent to the cash team for payment posting
- Prioritizes workload and ensures cash is posted accurately and timely in accordance with the cash processing center standards through the AS400
- Understands different approaches to claim resolution based on internal coding of claim
- Associate may need to initiate refunds, provide detailed spreadsheets, research Provider Line Balance or provide other information to 3rd Party payers that will result in a successful reconciliation of funds
- Communicates with 3rd Party Payers, and internal departments to achieve appropriate posting or reconciliation of cash
- Collaborates with the Co-Pay Recovery Team to resolve co-pay balances and prevent write offs when the company has a payment in unapplied cash
- Print and key reversals of variance or write-off batches per guidelines of Sarbanes Oxley requirements and Signature Compliance in order to apply payments received after adjustment
- Works with Department Manager in identifying any payer issues that may require special attention or need escalation
- Works to understand specific reasons for failed electronic reconciliation or recoup through the 835 process and discusses opportunities for improvement with management
- Maintains and accurately reports all reconciliation activity on monthly aging spreadsheets
- Records daily productivity results accurately in the Productivity Database
- Properly documents all communication and follow up that is necessary to apply payment or produce refund
- Works through assignments independently and timely with limited direction
- Able to handle high volume and significant workload
- Works with 3rd Party Claims Reconciliation Supervisor and/or Manager on special projects as needed
- Works 835 exception shared e-mail box as needed
- Performs other related duties as assigned
- Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
- High School graduate, GED or equivalent experience is required
- Associates degree, 4 year college or technical degree is preferred
- 1 year cash or claims reconciliation, Accounts Receivable and/or collections experience is required
- Third Party Billing or collections/billing experience in the healthcare industry is preferred
- Understanding of REVENUE CYCLE functions within pharmacy practice or equivalent setting is preferred
- Proficiency in MS Office Products (Excel, Word) and basic computer knowledge is required
- Excellent time management skills and attention to detail is required
- AS400 Computer Systems Experience is preferred
This is an excellent opportunity to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.
Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.
Employment Type: FULL_TIME
