Pharmacy Billing Specialist - Health Direct

For over 50 years, the HealthDirect team has been dedicated to the unique pharmacy needs of individuals residing in Long-Term Care (LTC) facilities such as nursing homes and assisted living facilities, as well as correctional facilities and group homes.”.  On a daily basis our team provides prescription medications, over-the-counter products, clinical consulting services, and specialty pharmacy services to more than 50,000 residents. 

HealthDirect is a division of KPH Healthcare Services, a billion dollar, 100% employee owned provider of pharmaceutical and healthcare services. KPH is comprised of four divisions – Kinney Drugs, ProAct Inc., HealthDirect and Noble Health Services.  The family of KPH Healthcare Services began with Kinney Drugs retail in 1903.  All KPH family company values stem from Kinney’s long-standing commitment to trust and community-minded health solutions.  

As a team, HealthDirect has achieved significant growth. Over the past 6 years we have grown from four pharmacies in two states to 20 pharmacies across eight states.  Our team has grown to over 900 employees and we are looking to add another – possibly you!

Scope of Responsibilities: Works under minimal supervision. 

Job Summary: Assist in centralized billing of all claims

Job Duties:

• Responsible for accurate data entry of resident insurance information.
• Review of resident face sheets and make corrections if needed.
• Verify and change any financial pay statuses.
• Provides customer service and problem resolution to assigned facilities
• Identify errors that caused claim denial daily
• Correct all necessary data        
• Re-bill claims as needed
• Interact with HealthDirect employees and various outside agencies
• Assist in the overall automation of billing procedures
• Assist end of month bill process
• Visit clients to go over monthly billing statement
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Attendance Requirements:

• Must be available, and on-time for scheduled work shifts
• Must be able to work nights and weekends as required.

Educational Requirements:

• Minimum: High School Diploma
• Preferred: AS Degree or Higher in Business Administration or related field

Experience:

• Preferred: 1 to 2 years Medicare billing
• Preferred: General knowledge of Medicare D Insurance, Medicare A, Accounting, Third Party Processing and/or Pharmacy Operations.

Required (Vermont Employees):

• Registered with the State of Vermont as a Pharmacy Technician
• I have read and understand the above job description, and believe that I will be able to perform the above duties with training.

Special Conditions of Employment:

• Drug test
• Initial and continuous exclusion and sanction/disciplinary monitoring
• Any and all additional eligibility requirements based on the specific position

Job Skills Required:

• Excellent phone communication skills
• Strong organizational skills
• General computer and keyboarding skills
• Ability to complete responsibilities with minimal supervision
• Successful completion of a pre-employment and/or random drug screening test

Required Training:

• HIPPA Privacy Course
• HIPPA Security Course
• Fraud, Waste, and Abuse Course

Behavioral Traits Required:

• Cooperation: Must work harmoniously and effectively with fellow employees, supervisors and other in contact with
• Initiative: Must work within supervision guidelines and assume additional responsibilities
• Flexibility: Must be willing to work variable work schedules, assist others as requested and available, and be willing to perform all assigned work
• Adaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiences
• Involvement: Must enjoy the demands of the job and work with interest and enthusiasm
• Customer Service: Must provide appropriate customer service (for Kinney customers, fellow employees and business partners), listen attentively to their needs and respond appropriately
• Safety: Must take care of equipment and employ good safety habits
• Leadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teams

Compensation:

$18.44 - $24.01 an hour

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education. 

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.