Payment Specialist

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

Responsibilities

• Accurately and timely applies all payments and contractual adjustments according to departmental procedures.

• Process refunds for patient/insurance overpayments monthly. 

• Responsible for identifying payer trends & reporting to the management team.

• Analyzing contracts, understanding per-diem rates Vs. drug rates. 

• Responsible for making the appropriate adjustments to claims. 

• Forward paper denials included on payment advice & remittance to A/R coordinator for daily follow-up. 

• Perform other duties as assigned by the supervisor. 

Skills & Abilities

• Strong customer service and interpersonal skills

• Effective written and verbal communication

• Excellent organization, problem solving skills and attention to detail

• Meet the quality assurance and benchmark standards set by the management team

• Knowledge of patient accounting systems, third party billing and collections guidelines

• Ability to communicate with patients, payers and outside agencies through telephone, electronic and written correspondence.

• Collections or medical billing experience with an understanding of HCPCS, ICD-10 and medical terminology is preferred.

• Familiarity with third party payer guidelines, reimbursement practices and available financial resources is preferred.

• CPR+, HCN 360 and/or Caretend knowledge preferred

Requirements

• Good computer & communication skills. 

• Knowledge of medical terminology. 

• One-year experience in billing, cash posting, and collection procedures, preferably in healthcare.

• Able to handle multiple tasks in a stressful environment.   

• CPR+ and or Caretend experience

CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.