What You'll Do

Claims Management & Accounts Receivable

• Research and resolve denied, underpaid, and outstanding claims.
• Submit reconsiderations, appeals, and claim resubmissions as appropriate.
• Manage accounts receivable with a strategic focus on aging balances and timely collections.
• Audit patient accounts across multiple systems to ensure accuracy, completeness, and compliance.
• Identify billing discrepancies and take ownership of accounts through final resolution.
• Maintain accurate documentation of account activity and claim status.

Collections & Provider Relations

• Follow up on outstanding balances with insurance carriers and other payers.
• Communicate with attorneys regarding litigated claims to obtain case updates and facilitate payment.
• Request Letters of Medical Necessity (LMNs) and supporting documentation from treating physicians.
• Build positive working relationships with internal teams, providers, and external partners to resolve billing issues efficiently.

Pre-Dispensing Verification

• Complete billing verification before medication is dispensed to ensure claims are clean and payable.
• Verify insurance coverage, authorizations, and required documentation.
• Collaborate with internal departments to minimize delays and create a seamless patient experience.

Who You Are

• Experienced in medical billing, pharmacy billing, accounts receivable, or healthcare revenue cycle management.
• Workers' Compensation and/or DaisyBill experience is a strong plus, but not required.
• Familiar with Liberty, DaisyBill, or similar pharmacy billing and accounts receivable systems.
• Skilled at researching and resolving complex billing issues across multiple platforms.
• An excellent communicator with strong verbal and written communication skills.
• Highly organized with exceptional attention to detail and strong time management skills.
• Able to prioritize competing responsibilities while effectively managing aging accounts.
• Self-motivated and comfortable working independently in a fast-paced environment.
• Proficient in Microsoft Office, particularly Excel.
• Committed to accuracy, accountability, and delivering exceptional service to patients and partners.