Description
POSITION SUMMARY
This position prepares regulatory, HIPAA and payer compliant prescription insurance claims for billing with patient and third party pharmacy benefit managers; completes bill status for electronic transmission, and completes all processing and documentation necessary for initial or secondary billing. The position follows-up on pending, denied, and delinquent accounts, and responds to inquiries regarding prescription billing records.
About Fairbanks Memorial Hospital
Fairbanks Memorial Hospital is a non-profit facility owned by the Greater Fairbanks Community Hospital Foundation. A Joint Commission-accredited facility with 152 licensed beds, Fairbanks Memorial Hospital is the primary referral center for residents of Alaska's interior with a strong patient-to-nurse ratio and Shared Leadership Infrastructure. In addition to our exceptional clinical environment, our location offers incomparable lifestyle rewards away from work. In Fairbanks, small-town living, spectacular natural beauty and endless recreation combine to create a one-of-a-kind place to live, work and play.
+ Prepares electronic and paper claims in accordance with department standards to ensure compliance, accuracy of patient and payer information, and proper reimbursement according to contractual agreements.
+ Monitors outstanding claims and reports and follows through as needed to ensure prompt payment; processes prescription claims appeals to appropriate insurance payers; responds to inquiries regarding patient billing records.
+ Performs monthly reconciliations of all pharmacy billing accounts.
+ Maintains current knowledge of regulatory rules and insurance billing requirements and restrictions.
+ Works with the companies Charge Description Master (CDM) including assigning of Healthcare Common Procedure Coding System (HCPCS) codes to products.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Foundation Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge. Must obtain license by the State of Alaska as a pharmacy technician within 6 months of hire.
Requires knowledge of patient financial services, or financial collecting services or insurance industry experience
processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences.
Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are
required.
PREFERRED QUALIFICATIONS
One year of experience in a prescription billing or similar position is preferred. The ability to become a PTCB Certified Pharmacy Technician within the first year is preferred. Coding experience/knowledge of HCPCS codes is preferred with the ability to become certified as a coder within the first year. Additional related education and/or experience preferred.
Additional related education and/or experience preferred.
Foundation Health Partners is an EEO/AAP employer; qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.
Job Number: 2
Shift Schedule: Days
New Grad: Yes
External Company Name: Foundation Health, LLC
External Company URL: fmhdc.com
Street: 1650 Cowles Street
