Hy-Vee Pharmacy Solutions, Billing/Finance Coordinator - Full Time
Company Name:
Hy-Vee Food Stores
Page 1 Job Description Benefits/Billing Coordinator Division: Operations Job Relationships: (cid:1) (cid:1) Reports to: Pharmacy Manager / Accounting Coordinator Supervises: N/A Job
Responsibilities: General duties include but are not limited to: 1. Prioritize the urgency of accounts that are pending contact before shipment of medications 2. Coordinates payment between the various payers and keeps the patient involved as needed. Contacts the payer in the event of a denial and determines the best method for resolution of the claim. Tracks eligibility issues. 3. Knows HPS HIPAA policies and maintains patient confidentiality at all times. Tracks and records the return of HIPAA privacy statements. 4. Works as a team member with all other departments to verify benefits, resolve past due accounts issues and correct pharmacy claim errors. 5. Responsible for fulfilling all patient requests for documentation. 6. Maintains computer messaging to assist pharmacy staff with identifying problem account before medications are shipped. 7. Knowledgeable of the systems and software applications used by Amber and HPS. 8. Working knowledge of commercial insurance OOP expenses, Medicare deductibles and coinsurances and Medicaid policies. 9. Assists in downloading EOBs and payment reconciliation via entry into QS1 system. 10. Processes 30, 60 and 90 day past due notices and follow through with Collections if necessary. 11. Adheres to directives outlined in HPS Employee handbook and directives issued by the management. 12. Consults with patients to resolve account issues and unpaid balances via the telephone or in person at the receptionist desk. 13. Develops payment plans tailored to meet the individual patients need while keeping HPS best interest in mind. Will secure payment before shipment if warranted. 14. Handles all daily credit card processing and automatic payment plan authorization, Debits and the agreed upon account or credit card on the authorized date. Ensure that all pay at time of order accounts have been handled timely and accurately. 15. Works as a team member with the Enrollment to clarify patient benefits. Must be able to identify the staff member whose area of expertise will resolve the issues. Billing Coordinator Page - 1 Amber Enterprises, Inc. d.b.a. Amber Pharmacy January 2012 Page 2 16. Reviews flagged notices from pharmacy and prioritizes the urgency of accounts that are pending contact and payment resolutions before shipment of medications. 17. Monitors balances of new referrals and pay at the time of order accounts to ensure collection of payment is done in a timely and accurate manner. 18. Post daily patient and insurance check payments received. 19. Coordinator of Benefits between payers in a timely manner. 20. Print Reports and submit paper/electronic claim forms when necessary. 21. Work Closely with Ambers Director of Financial Services and Director of Customer Accounts when necessary. This list is in no way to be used as an all-encompassing list of duties. The intention of the aforementioned job description is to be used as a guide to assist in accomplishing company and department objectives, covering only primary functions and responsibilities. Minimum
Qualifications: Minimum
Qualifications: Minimum
Qualifications: Minimum
Qualifications: (cid:1) High School diploma or equivalent (cid:1) Basic knowledge of phone and computer technology (cid:1) Knowledge of insurance process and coding (cid:1) Experience with claims reconciliation Approved By: Employee: _________________________________________________________________________ Date __________ Manager:__________________________________________________________________________ Date __________ Billing Coordinator Page - 2 Amber Enterprises, Inc. d.b.a. Amber Pharmacy January 2012Estimated Salary: $20 to $28 per hour based on qualifications.
Hy-Vee Food Stores
Page 1 Job Description Benefits/Billing Coordinator Division: Operations Job Relationships: (cid:1) (cid:1) Reports to: Pharmacy Manager / Accounting Coordinator Supervises: N/A Job
Responsibilities: General duties include but are not limited to: 1. Prioritize the urgency of accounts that are pending contact before shipment of medications 2. Coordinates payment between the various payers and keeps the patient involved as needed. Contacts the payer in the event of a denial and determines the best method for resolution of the claim. Tracks eligibility issues. 3. Knows HPS HIPAA policies and maintains patient confidentiality at all times. Tracks and records the return of HIPAA privacy statements. 4. Works as a team member with all other departments to verify benefits, resolve past due accounts issues and correct pharmacy claim errors. 5. Responsible for fulfilling all patient requests for documentation. 6. Maintains computer messaging to assist pharmacy staff with identifying problem account before medications are shipped. 7. Knowledgeable of the systems and software applications used by Amber and HPS. 8. Working knowledge of commercial insurance OOP expenses, Medicare deductibles and coinsurances and Medicaid policies. 9. Assists in downloading EOBs and payment reconciliation via entry into QS1 system. 10. Processes 30, 60 and 90 day past due notices and follow through with Collections if necessary. 11. Adheres to directives outlined in HPS Employee handbook and directives issued by the management. 12. Consults with patients to resolve account issues and unpaid balances via the telephone or in person at the receptionist desk. 13. Develops payment plans tailored to meet the individual patients need while keeping HPS best interest in mind. Will secure payment before shipment if warranted. 14. Handles all daily credit card processing and automatic payment plan authorization, Debits and the agreed upon account or credit card on the authorized date. Ensure that all pay at time of order accounts have been handled timely and accurately. 15. Works as a team member with the Enrollment to clarify patient benefits. Must be able to identify the staff member whose area of expertise will resolve the issues. Billing Coordinator Page - 1 Amber Enterprises, Inc. d.b.a. Amber Pharmacy January 2012 Page 2 16. Reviews flagged notices from pharmacy and prioritizes the urgency of accounts that are pending contact and payment resolutions before shipment of medications. 17. Monitors balances of new referrals and pay at the time of order accounts to ensure collection of payment is done in a timely and accurate manner. 18. Post daily patient and insurance check payments received. 19. Coordinator of Benefits between payers in a timely manner. 20. Print Reports and submit paper/electronic claim forms when necessary. 21. Work Closely with Ambers Director of Financial Services and Director of Customer Accounts when necessary. This list is in no way to be used as an all-encompassing list of duties. The intention of the aforementioned job description is to be used as a guide to assist in accomplishing company and department objectives, covering only primary functions and responsibilities. Minimum
Qualifications: Minimum
Qualifications: Minimum
Qualifications: Minimum
Qualifications: (cid:1) High School diploma or equivalent (cid:1) Basic knowledge of phone and computer technology (cid:1) Knowledge of insurance process and coding (cid:1) Experience with claims reconciliation Approved By: Employee: _________________________________________________________________________ Date __________ Manager:__________________________________________________________________________ Date __________ Billing Coordinator Page - 2 Amber Enterprises, Inc. d.b.a. Amber Pharmacy January 2012Estimated Salary: $20 to $28 per hour based on qualifications.
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