Billing Specialist

About Clarest Health

At Clarest Health, we are dedicated to transforming patient care by providing innovative and efficient pharmacy services to healthcare facilities. Our commitment to excellence ensures that our automated dispensing solutions streamline medication management, improve patient outcomes, and enhance the overall efficiency of healthcare operations. As a part of the Clarest Health team, you'll be contributing to a mission-driven organization that is redefining the future of pharmacy services and making a meaningful impact on the lives of patients and healthcare professionals across the nation.

Job Summary

The Pharmacy Billing Specialist handles daily account maintenance and data entry, claims adjudication, and customer service collaborations with Benefits Managers and Responsible Parties. This role involves producing monthly statements and troubleshooting processing concerns while adhering to CMS and LTC Guidelines.

Location

Remote

Salary

$17-$20 per hour

Schedule

Monday – Friday | 1st Shift

What We Offer:

• Comprehensive Medical, Dental and Vision Insurance (as low as $13.33/pay)
• Paid Time Off
• Free Virtual Care – Telemedicine
• 401k with company match
• Referral Bonuses
• Life Insurance
• Make a difference in the lives of others!
• We are growing and that means more opportunities

Key Responsibilities:

• Facility census processing.
• Data entries.
• Insurance and responsible party validation.
• Claims processing to Third-Party vendors' electronic, online, or manual process.
• Pre-billing accuracy validation and corrective actions.
• Revenue Cycle invoice and statement production.
• Internal and external correspondence via email, phone, fax.
• Provides customer support for the purpose of clarification or rectification of billing inquiries.
• Ensure billing aligns with the census, therapeutic interchanges, and contractual obligations.
• Assist in billing tasks as needed when directed.
• Adhere to Clarest’s Code of Conduct, follow Clarest Compliance policies and procedures, and report any suspected violations of any federal or state laws to either their direct supervisor, Human Resources or the Compliance Officer.

Qualifications:

• One Year Experience in LTC Billing & Reimbursement.
• Demonstrate ability to use and or learn Framework and DocuTrak.
• Ability to maintain confidentiality including but not limited to HIPPA.
• Understanding relevant laws and billing best practices.

Skills + Abilities:

• Intermediate knowledge of Medicare D Insurance, Medicare A, and all potential payers.
• Knowledge of Third-Party Processing, and/or Pharmacy Operations
• Understand the importance of accuracy and the attention to detail.
• Ability to multi-task and prioritize in a fast-paced environment.
• Experience with Word, Excel, Outlook, and Teams.
• Ability to organize and coordinate tasks.
• Demonstrate ability to collaborate with team members and individual across Clarest to process daily job requirements.
• Excellent oral and written communication skills to be able to clearly articulate team and Clarest needs to perform job responsibilities.

Equal Opportunity Employer

Clarest is an Equal Opportunity Employer. Reasonable accommodations will be made to enable individuals with disabilities to apply for a job or to perform the essential functions of their job. Please advise us if you require a reasonable accommodation.

Key skills/competency

• Billing Specialist
• LTC Billing
• Claims Adjudication
• Revenue Cycle
• HIPAA
• Medicare D
• Third-Party Processing
• Pharmacy Operations
• Data Entry
• Customer Service