High school diploma or GED equivalent, 1-3 years of related work experience, Experience in medical field and record management, Strong customer service background.
Key responsabilities:
Monitor performance and compliance of reporting personnel
Ensure timeliness and accuracy of billing
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CarepathRx is transforming pharmacy care delivery for health systems and hospitals, delivering improved patient outcomes that drive clinical, quality and financial results.
CarepathRx provides the industry’s most comprehensive hospital pharmacy care delivery model, providing support across the patient’s complete healthcare journey—across multiple care settings, from hospital to home, no matter the patient acuity level.
We take an enterprise approach to pharmacy care delivery, providing a powerful combination of technology, market-leading clinical pharmacy services, and wrap-around services. This comprehensive, end-to-end approach enables health systems and hospitals to optimize pharmacy performance across the entire enterprise, including:
- Fully integrated pharmacy operations
- Expanded healthcare services
- Improved ambulatory access
- Minimized clinical variation
- Enhanced clinical patient outcomes
- New revenue streams
- Optimized health system revenue growth
For patients this means a more seamless experience and better overall health. And for clients, it means pharmacy is no longer a cost center—it’s a results generator. Today, CarepathRx works with more than 15 health systems and 600 hospitals nationwide.
Monitors the performance and compliance of reporting personnel and provides feedback via performance evaluations and disciplinary action when necessary.
Provides updates to the team regarding changes in contracts/internal processes.
Conducts staff meetings and updates personnel on company updates.
Ensure achievement of productivity standards and adherence to regulations and standards of performance and accreditation.
Acts as a resource to all personnel to resolve problems and answer questions regarding billing operations.
Report to leadership of dashboard status, analytics, and billing trends
Ensure the timeliness and accuracy of billing
Meet quality assurance, benchmark standards, and maintain productivity levels as defined by management.
Performs other duties as assigned
Qualifications
Background investigation (company-wide)
Drug screen (when applicable for the position)
Valid driver's license in state of residence with a clean driving record (when applicable for the position)
High school graduate or equivalent. Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary.
High school diploma or GED equivalent
One to three years of related prior work experience in a team-oriented environment
Experience in medical field and administrative record management
Strong customer service background
Skills & Abilities
Must have experience processing pharmacy claims
Ability to communicate with patients, payors, outside agencies, and public through telephone, electronic and written correspondence.
Effectively communicate in English; both oral and written, with physicians, location employees and patients to ensure questions and concerns are processed in a timely manner.
Helpful, knowledgeable, and polite while maintaining a positive attitude
Interpret a variety of instructions in a variety of communication mediums
Knowledge of Home Infusion
Knowledge of insurance policies and requirements
Knowledge of medical billing practices and of billing reimbursement
Maintain confidentiality and practice discretion and caution when handling sensitive information.
Multi-task along with attention to detail
Must be able to accurately perform simple mathematical calculations using addition, subtraction, multiplication, and division
Self-motivation, organized, time-management and deductive problem-solving skills
Work independently and as part of a team
Collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred.
Familiarity with third party payor guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial
Basic knowledge of Microsoft Office
Knowledge of HCN 360, CPR+ and CareTend preferable
Medicare knowledge of billing requirements specific to DMEMAC
Required profile
Experience
Spoken language(s):
English
Check out the description to know which languages are mandatory.