Billing Specialist-Mail Order

About the role

Responsible for all aspects related to adjudication and billing of mail order prescriptions in a pharmacy setting.

Responsibilities

• Responsible for monitoring adjudication queue(s)
• Responsible for contacting members and prescribers on non-covered items
• Facilitate prior authorization process for customers through designated PA portals
• Provide professional communication to contracted clients
• Provide timely resolution to all internal communication inquires relating to rejections or overrides
• Customer service coverage for outbound calls and directing incoming calls
• Provides resolution to customer service issues to ensure member satisfaction
• Maintain and keep reasonable production as determined by supervisor
• May assist in orienting and training new employees
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned