Henry Ford Health is seeking a Senior Pharmacy Billing Analyst to support revenue cycle management across pharmacy operations. This role is responsible for identifying and determining the accuracy of third-party payments, denials, and rejections to ensure claims are paid correctly. The position also provides training and resources to internal and external team members in accordance with department guidelines.
Key responsibilities include customer support, troubleshooting claim adjudication issues, verifying insurance coverage and coordination of benefits, responding to insurance audits and claim reversals, resolving credit balances, submitting third-party medical and pharmacy CMS-1500 claims, managing the First Fill Program, posting third-party payments, resolving delinquent accounts, and overseeing the Patient Financial Assistance Program.
Associate degree required.
Minimum of 5 years of pharmacy experience.
Minimum of 5 years of third-party / revenue cycle management experience.
Medical billing experience preferred.
Knowledge of Medicare Part-B billing guidelines.
Ability to analyze and improve billing procedures.
Strong analytical and problem-solving skills.
Strong understanding of medical, clinical, and pharmacy terminology.
Working knowledge of personal computers and business software such as Microsoft Office.
Strong organizational and time management skills with the ability to prioritize multiple tasks.
Strong interpersonal communication skills and experience working with customers.
Pharmacy Technician License and Certification required.
Location
Michigan, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
3 weeks ago