A typical day in the life of a Medical Billing and Coding Specialist will include the following:
The responsibilities include, but are not limited to the following:
- Assist with determining coverage and access options available for a specific medication or procedure
- Collect and analyze information and resources related to local, regional or national payer coverage or claim submission process
- Clearly articulate complex reimbursement and billing information to HCPs, their office staff and/or patients to ensure understanding of coverage benefit and financial responsibility
- Educate provider offices on local and regional payer coverage policies, issues, coding changes, and appropriate claims submission processes
- Educate offices about the medical necessity requirements for coverage and provide education support for the office to submit pre-determinations, appeals and/or peer to peer reviews with payors, as applicable
- Assist offices to understand payor denied or underpaid claims and provide education, as applicable, for the office to resolve of rejected, denied or underpaid claims
- Educate HCPs, their office staff and/or patients on appropriate resources for questions about co-pay, coinsurance, out of pocket costs, deductibles and other financial assistance or coverage related questions
- Serve as a patient advocate and enhance the customer experience for all callers by acting as a single point of contact and a compassionate voice for all providers and patients
- Minimum of (two) 2 years’ of billing and coding experience is preferred
- Bachelor’s degree in arts and sciences, social work, public health administration or a related field preferred
- Billing and coding diploma or certificate strongly preferred
High School diploma or equivalent is required
- Strong understanding of medical terminology background is preferred
- Background working directly within physician practices or outpatient clinics billing commercial insurances, Medicare, and Medicaid preferred
- Bi-lingual in English and Spanish or Chinese/Mandarin is a plus
- All employees working onsite in a PharmaCord facility are required to be vaccinated against COVID-19
- We are located in the River Ridge Commerce Center at 150 Hilton Drive, Jeffersonville, IN. You must be willing to work in this location; PharmaCord does reimburse for tolls if applicable, at the frequent user rate. This rate is applied after 20 round trips per month (valued at $574.60 per year)
- While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, use hands to type, handle or feel; and reach with hands and arms. Must be able to type 35 WPM with 97% accuracy.
- Ability to travel as needed
Any offer of employment is contingent on completion of a background check and drug screen to company standard. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
At PharmaCord, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. PharmaCord is proud to be an equal opportunity employer.
PharmaCord is a COVID-19 employer. All employees working onsite in a PharmaCord facility are required to be vaccinated against COVID-19. PharmaCord is unable to sponsor employees at this time.
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