Pharmacy Billing Team Lead

Title: Pharmacy Billing Team Lead

Dept: BILLING & REIMBURSEMENT
Reports To: Sr. Mgr. of Revenue Cycle
Location: MSO

Salary: $24-28/ hour

Position Summary
The goal of this team leader is to manage and maintain a well-balanced and successful work environment for their team. The leader is responsible for the efficiency of the individual, group, or team assigned to them and collaborates with other leaders to ensure processes and procedures result in the desired outcome. Billing leads also provide support to our CSMs and assist in the resolution to client concerns.
Essential Functions – primary position responsibilities:
• Lead, manage, develop, and coach staff members through daily workflow and processes.
• Monitor production and redistribute daily, weekly, and monthly workflows in multiple applications.
• Monitor open batches and aid staff with the closure of claims requiring ECS.
• Audit pre-billing verification and monthly invoices or statements for QA, audit and more.
• Proactively review procedures, and distributions, collaborate with other department leaders and management as well as coaching/mentoring and providing performance information/feedback to associates to identify areas for efficiency/process improvements.
• Recognize individuals and teams for meeting/exceeding goals, maintaining streaks, etc.
• Act as a subject matter expert for internal customer support when needed.
• Create billing for multiple payor types and pharmacy sites and produce statements and invoices for various customers.
• Proactively handle customer-facing communications and resolution of escalations in relation to our facility and patient clients and contracted vendors.
• The ability to adhere to Clarest’s Code of Conduct, follow Clarest Compliance policies and procedures and report any suspected violations of any federal or state laws to either their direct supervisor, Human Resources, or the Compliance Officer

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of this employee for this role.

Required Skills (Education/Certification/ Licenses/Years of Experience):
• Advanced knowledge of Medicare D Insurance, Medicare A, Accounting, Third Party Processing and LTC Pharmacy Operations.
• Staff management experience.
• Leadership soft skills and High Emotional Intelligence.
• Ability to maintain confidentiality including but not limited to HIPPA.

Competencies
• Excellent verbal and written communication skills to manage, coach employees, as well as collaborate with team members and outside customers.
• Strong importance for accuracy and the attention to detail to meet the quality assurance standards.
• Ability to objectively review employees work and provide comments, feedback, all with a few toward improvement.
• Implementing company policies, managing daily operations, and providing guidance and support to team members.
• Providing leadership, encouragement, motivating and providing suggestions, to reach team goals.
• Organizing and planning team meetings, discussing assigning duties, addressing concerns and troubleshooting problems.
• Ability to multi-task and prioritize in a fast-paced environment.
• Intermediate use of Word, Excel, Outlook, and Teams.
• Intermediate experience with Framework LTC and DocuTrack preferred.

Supervisory Responsibility: Yes
Budget Responsibility: None
Describe the nature and scope of independent decisions made in this position:
• Organization, prioritization, and manage team guidance will be paramount to the success of continued assessment and modification of workflows and end-user production with a focus on meeting timeline goals and maintaining compliance.
• Ability to evaluate process path based off information obtained from insurance or another payer, in accordance with Clarest values and department protocols.
• Responsible for managing queue of workload and reporting any concerns to leadership.

Work Environment: This job is performed remotely and requires a dedicated, secure workspace where PHI cannot be easily accessed. Hardwired high-speed internet is required, no Wi-Fi. All equipment will be supplied by the employer. (Computer, keyboard, mouse, monitors, audio/video phone calls,).
Physical Demands: Deskwork, sitting for long periods, extended periods of screen time, and phones. No heavy lifting is required.
Position Type/Expected Hours: The role is a full-time, hourly rate, 40-hour-per-week Monday through Friday position.
Travel (if yes, percentage of travel time required) None.
Clarest is an Equal Opportunity Employer. Reasonable accommodation will be made to enable individuals with disabilities to apply for a job or to perform the essential functions of their job. Please advise us if you require reasonable accommodation.