Pharmacy Billing Specialist

Description

Are you an experienced Claims Specialist who is a compassionate team collaborator who puts people first, shows care and concern for all and enjoys the challenge of following, resolving and reconciling third party claims and contributing to pharmacy business? Do you consider yourself a self-starter with excellent interpersonal, communication and customer service skills? Do you want to join an organization that is focused on Servant Leadership?

 

If you answered YES to any of these questions, then we invite you to bring your “roll-up-your sleeves and get the job done” attitude and commitment by joining our Devereux Advanced Behavioral Health team!

Being a Pharmacy Claims Specialist has its Advantages

In this role, you will collaborate with other dedicated professionals, internally and externally, who share your passion for helping individuals in need. We offer:

• A unique opportunity where the work you perform will support Devereux’s National Center and Centers throughout the country with pharmacy related claims, resulting in contributions that have relevance to the provision of services to individuals;
• A Supportive team collegial work atmosphere with the ability to deliver high-quality Financial support data driven decisions;
• Salary Range: $17.22 to $19.64

Quality Health Pharmacy (QHP), a division of Devereux, was founded at our Texas Center in 1992. In response to the evolving needs of our more than 15 centers nationwide, we continue to grow and strengthen our pharmacy program. Today, Devereux operates pharmacy programs in Cherry Hill, NJ; Orlando, FL; and League City, TX.

 

Under the guidance of the Vice President for Pharmacy, this role will provide billing support to Worcester and the surrounding communities, upholding processes and procedures that align with best practices, as well as all applicable regulatory, accreditation, and professional pharmacy standards.

 

We are proud to offer:

• ASCEND- Career Accelerator Program  A program designed to empower you. From personalized coaching to financial assistance, ASCEND is your ticket to reaching your full potential.
• A comprehensive health and welfare program.  Click mydevereuxbenefits.org for more information.

Our ideal candidate is a great collaborator and can successfully juggle multiple priorities in a fast-paced environment.

In this role you will:

 

• Perform timely preparation and electronic submission of claims to third party carriers and guarantors;
• Perform utilization review and correction of rejected claims, answering inquiries on a timely basis;
• Complete and submit other pharmacy documents and paperwork, e.g., electronic records, reports, monthly medication charge and usage reports;
• Assist in setting up contracts, Medicaid applications and renewals;
• Communicate with all funding agencies, including private payers, regarding claim processing procedures and payment difficulties;
• Prepare and disseminate information requested by government agencies and external auditors;
• Research all non-applied credit line items;
• Perform system integrity checks and maintenance and coordinate and respond to internal and external audit requests.

  

Qualifications

• High School Diploma or G.E.D. Some college coursework is highly preferred;
• Pharmacy Technician Certification is preferred;
• Minimum of three years of experience in pharmacy and/or performing Pharmacy insurance billing and collection duties is preferred;
• Pharmacy pricing and medication knowledge is preferred;
• Computer proficiency in the Microsoft Office products;
• Strong customer service skills and team player with the ability to adapt to change and work effectively in a cross-functional team environment;
• Multi-tasker with ability to meet deadlines;
• Valid driver’s license and car is required.

Company Overview

Company Overview 

Devereux is one of the nation’s largest nonprofit organizations, providing services, insight and leadership in the evolving field of behavioral healthcare. Founded in 1912, Devereux operates a comprehensive national network of clinical, therapeutic, educational and employment programs that positively impact the lives of 10,000+ children, adults – and their families – every year.    

 

Our Mission: Devereux changes lives – by unlocking and nurturing human potential for people living with emotional, behavioral or cognitive differences.    

With nearly 6,500 employees working in programs across the country, Devereux is a trusted partner for families, schools and communities, serving individuals in the areas of autism, intellectual and developmental disabilities, specialty mental health, education and foster care. 

 

Our Culture, Our Expectations  

At Devereux, Servant Leadership is embedded throughout our culture and every aspect of our organizational framework. Our mission-driven, people-first mindset is at the heart of the compassionate and high-quality programming we provide – every day – for the individuals and families we serve, and other key stakeholders. Devereux offers challenging and exciting work, and our team environment creates an empowering, positive and rewarding atmosphere. To be successful at Devereux, you will: put the needs of others first, feel called to serve and called to lead. As a member of our team, you will be a significant part of our commitment to providing a welcoming and supportive work environment across all programs and services, and within all policies and employee practices.  

 

We believe a workplace rooted in inclusivity – offering a sense of belonging to all those who walk through our doors – is fundamental to delivering the highest quality healthcare services. Through open dialogue and the creation of brave spaces, we will engage in work that gives each of us a chance to change the world – one person, one family, one community at a time. 

 

What Devereux Offers You 

In addition to a competitive salary, Devereux provides a comprehensive health and welfare program to eligible full-time employees, family members and domestic partners. Eligible employees are eligible to start benefits after 30 days of employment. In addition, we offer;  

 

• Medical (including telemedicine via phone, web, app), dental, prescription drug, preventative care, and mental health services. 

• Student loan debt assistance, tuition reimbursement and continuing education assistance. 

• Generous time-off (start accruing 1st day), 403(b) retirement plan with matching benefit, and voluntary/employee paid supplemental life and accident coverage. 

• Employee assistance / work-life balance program. 

Visit www.mydevereuxbenefits.org to see why Devereux is a great place to work!  

 

Devereux is a drug-free workplace, drug screening required. EOE