Pharmacy Reimbursement Coordinator IIJohns Hopkins Medicine • Baltimore, Maryland, United States
Pharmacy Reimbursement Coordinator II
Johns Hopkins Medicine
- Baltimore, Maryland, United States
- Baltimore, Maryland, United States
À propos
What Awaits You?
* Career growth and development
* Diverse and collaborative working environment
* Competitive Benefits Package
* Tuition Assistance
JOB SUMMARY:
The Pharmacy Reimbursement Coordinator II performs advanced-level billing and accounts receivable functions for outpatient pharmacy services. This role is responsible for accurate and timely billing to government payors, international and domestic third-party payors, patients, and Johns Hopkins programs to ensure optimal reimbursement. The incumbent demonstrates expertise in reimbursement policies, including government and international payor requirements, and independently researches and resolves complex billing and collection issues. This role serves as a resource to team members, supports training efforts, and maintains strong working relationships with internal stakeholders and external payors.
Minimum Qualifications:
* High School diploma or equivalent required
* Minimum 2+ years of experience in pharmacy and/or medical billing required
* Registration with the State Board of Pharmacy, in the state in which work is performed, required upon hire
Day shift- Monday- Friday 8am-4:30pm
Remote- Must have the ability to go onsite in Baltimore as needed. ONly local applicants will be considered.
Knowledge:
* Knowledge of accounting principles and billing/collections practices
* Understanding of insurance plans, including government and third-party payers
* Familiarity with healthcare billing systems and processes
* Navigate rapidly changing situations, from evolving patient needs to technological advancements, by remaining flexible, continuously learning, embracing new challenges, and quickly recovering from setbacks.
* Good written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy.
* Completes basic to moderately complex business support assignments; work involves minimal problem resolution.
* Strong attention to detail and self-directed to consistently ensure data integrity and accuracy
Essential Functions:
Billing Activities
* Processes and submits claims accurately and timely in accordance with departmental standards and payer requirements.
* Reviews billing reports and resolves errors to prevent delays and ensure compliance with timely filing guidelines.
* Maintains and monitors unbilled accounts and ensures appropriate follow-up.
* Reviews and processes required documentation (e.g., LOAs, EOBs, CMS-1500 forms) for billing accuracy.
* Troubleshoots discrepancies in pricing, authorizations, and documentation; collaborates with internal teams to resolve issues.
* Accounts Receivable (A/R) Follow-Up
* Maintains accuracy and integrity of assigned accounts receivable.
* Conducts timely follow-up, research, and resolution of outstanding balances.
* Identifies and resolves complex issues such as missing payments, underpayments, and payer discrepancies.
* Maintains detailed and accurate documentation of all
Compétences linguistiques
- English
Avis aux utilisateurs
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