Reimbursement/Billing Specialist - Escondido
1 month ago

Job summary
The Reimbursement/Billing Specialist is responsible for a portfolio of accounts receivable and oversees the billing cycle from charge review, claims submission and follow-up. This includes handling complex workflows such as charge review edits, claim edits and preparation,insurance follow-up, denial resolution, and necessary follow-up to ensure accurate payment.
Responsibilities
- Maintain a portfolio of accounts receivable for the pharmacy;
- Follow accounts through the Pharmacy revenue cycle; illiate with Revenue Cycle teams, payors and others to resolve account problems;
- Evaluate the payment status of outstanding third-party claims; illiate in meetings as needed to address payor concerns;
- Actively participates in both external third-party audits
and in internal audits and quality improvement initiatives,
maintains documentation of current workflows, allists with special projects,
and works closely with third party billing teams,
Dalrada Corporate Accounting teams,
and with Pharmacy Department Leadership
and Prior Authorization teams;
Job description
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