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Team Lead, Billing - Remote

Posted 4 days ago
Finance / Legal
Full Time
PA, USA

Overview

The Team Lead, Billing is responsible for managing third-party billing and collections, ensuring timely and accurate billing of claims while transforming hospital pharmacy into a revenue generator.

In Short

  • Manage third-party billing and collections.
  • Ensure timely and accurate billing of medical and NCPDP claims.
  • Identify and resolve root causes of claim rejections.
  • Maintain and reconcile batch postings for payers.
  • Train new employees and assist with billing inquiries.
  • Submit claims to insurance carriers for payment.
  • Monitor unbilled accounts and manage billing projects.
  • Communicate effectively with patients and payers.
  • Utilize billing software for order confirmations.
  • Ensure compliance with quality assurance standards.

Requirements

  • Associate degree preferred.
  • Experience in medical billing and understanding of ICD-10.
  • Familiarity with third-party payer guidelines.
  • Knowledge of Medicare guidelines for Home Infusion.
  • Proficiency in Microsoft Suite.
  • Strong organization and problem-solving skills.
  • Excellent communication skills.
  • Attention to detail.
  • Ability to work independently.
  • Customer service skills.

Benefits

  • Comprehensive medical, dental, and vision benefits.
  • 401(k) with company match.
  • Paid time off and volunteer time off.
  • Company-paid life insurance and short-term disability.
  • Flexible spending options.

C.M

CPRx MSO

ProHealth Pharmacy Solutions, through its subsidiary CarepathRx, is revolutionizing hospital pharmacy care delivery by transforming it from a cost center into a revenue-generating entity. The company combines advanced technology with market-leading pharmacy services and comprehensive wrap-around services to enhance patient outcomes and drive clinical, quality, and financial results. Serving over 15 health systems and 600 hospitals nationwide, ProHealth Pharmacy Solutions employs more than 2,400 professionals dedicated to optimizing pharmacy performance and improving healthcare access. The organization is committed to providing equal employment opportunities and fostering a drug-free work environment while offering a comprehensive benefits package to its employees.

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