Billing Supervisor - Adjudication
Company: Guardian PHarmacy, LLC
Location: Kernersville
Posted on: September 16, 2023
Job Description:
Kernersville, North Carolina, United States of America
Southern Pharmacy Services is part of the Guardian Pharmacy
Services network and prides itself on its customer service. Each
team member plays an integral part in the success of the
pharmacy.Schedule: Full Time, Monday-Friday 8a-5p, with a weekend
rotation.This role will be performed onsite at our closed-door
pharmacy in Kernersville, NC. - All patient interactions will be
over the phone.We Offer:
- Comprehensive training provided side by side with training
team.
- Must be comfortable working in a high-volume environment.
- We offer full time benefits including health, vision, dental
and matching 401k options.Support the team with all
billing/collections functions and ensure they are performed in a
timely and accurate manner. Ensure all relevant input is complete,
accurate, and fully adjudicated to ensure margin is maximized.
Responsible for the integrity of all batches and their timely
posting. Handle escalated billing issues and make sure full
customer satisfaction is reached for residents, responsible parties
and facility staff. Work with other departments as it relates to
billing and claims adjudication.Attributes Required:--- Work
Ethic/Integrity - must possess intrinsic drive to excel coupled
with values in line with company philosophy--- Leadership - ability
to lead project teams to deadlines, while maintaining strong team
orientation--- Relational - ability to build relationships with
business unit management and become "trusted advisor"--- Strategy
and Planning - ability to think ahead, plan and manage time
efficiently--- Problem Solving - ability to analyze causes and
solve problems at both a strategic and functional level--- Team
Oriented - ability to work effectively and collaboratively with all
team membersEssential job functions (include the following):---
Manage billing, A/R, and collection functions to ensure high level
of customer service is maintained; manage productivity to metrics
to include production & error rates--- Supervise team members, to
include: hiring, training, evaluating, scheduling, coaching,
disciplining, etc.--- Lead team in development and ongoing updates
for all operations training manuals to assist in new employee
training process; ensure written policies and procedures are
maintained and updated for each area/function--- Assist in month
end close processes, including statement prep, analysis reports,
etc.--- Provide analysis of operational reports such as unbilled
revenue; provide detailed explanation of variances and
corrections--- Lead and participate in regular team meetings for
direct reports and coordinate multi-department meetings to ensure
good communication and issue resolution; participate and lead
discussions as requested for operational meetings--- Serve as
subject matter expert on all department operating systems and
programs, including QS/1, DocuTrack, banking software, and others,
in order to provide assistance and analysis to department--- Ensure
all claims are adjudicated and batches composited and/or posted in
a timely manner--- Ensure the PA/rejection queue is updated and
resolved in a timely manner--- Quality check all patient and
insurance information data entered in the system--- Have a thorough
working knowledge of all department functions in order to
assist/support clearing bottlenecks in workflow and ensuring the
most efficient processes are followed--- Assist in answering phones
and providing customer service--- Provide customer account audits
when occasions arise--- Become cross trained in all areas of
department function so as to assist in clearing bottlenecks in work
flow--- Lead by example in all areas of role and supporting the
non-negotiable attributes: attitude, dependability, commitment,
productivity, efficiency and upholding policies and procedures---
Other essential functions and duties may be assigned as
neededEducation and/or Certifications:--- High School Diploma or
GED required; Bachelor's Degree preferred--- Pharmacy Technician
license/certification/registration (per state requirements);
National Certification preferred (PTCB) may be required (pharmacy
specific)Skills and Qualifications:--- 5+ years of related
experience (advanced degree may substitute for experience); at
least 3 years in high volume claims processing field--- Advanced
computer skills; pharmacy operations system experience
preferred/required--- Ability to work independently and deliver to
deadlines--- Ability to solve problems with minimal direction---
Great attention to detail and accuracy--- Ability to excel in a
fast-paced, team-oriented environment working on multiple tasks
simultaneously, while adhering to strict deadlines--- Quality
minded; motivated to seek out errors and inquire when something
appears inaccurateWork Environment:--- Ability to work flexible
hoursFull-Time employees working 30+ hours per week are eligible to
enroll in our comprehensive benefits package, which includes
medical, dental, vision, short and long-term disability, life and
supplemental life insurance, and PTO.All employees -are eligible to
enroll in our company matched 401(k) plan.
Keywords: Guardian PHarmacy, LLC, Winston-Salem , Billing Supervisor - Adjudication, Accounting, Auditing , Kernersville, North Carolina
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