Job description

BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

The Admissions Billing Coordinator is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. Works without significant guidance w/ basic understanding of multiple products (HMO, PPO, COB, etc.).

Primary duties may include, but are not limited to:

• Able to handle more complex claim with a good understanding of the application of benefit contracts, pricing, processing, policies, procedures, government regs, coordination of benefits,& healthcare terminology.

• Good working knowledge of claims and products, including the grievance and/or re-consideration process.

• Excellent knowledge of the various operations of the organization, products, and services.

• Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement.

• Researches and analyzes claims issues.

• Responds to inquiries, may involve customer/client contact.

Qualifications - External

Primary requirements:

• Requires a HS diploma or equivalent

• Minimum of 1 year of claims processing experience; previous experience using PC, database system, and related software (word processing, spreadsheets, etc.);

• Any combination of education and experience which would provide an equivalent background.

• 1 Year Specialty Pharmacy Experience (must be able to process , read and understand claims

Job Type: Full-time

Salary: $15.54 - $19.42 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Experience:

• ICD-10: 1 year (Preferred)

Work Location: Remote

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