Billing Clerk - Billing Analysis

National Billing Specialist Location Mississauga, ON L4V 1V8 : McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you.
The National Billing Specialist is responsible for delivering yearly pharmacy commercialization targets and achieving required performance objectives. The Billing Specialist will be responsible for overseeing the billing errors for the Pharmacy team, monthly reporting to our clients, and keeping our accounts receivables at an acceptable range for the billings done by the team. They will also act as a liaison between the billing team, pharmacy team, manufacturer clients, and patient support program as needed.
Review the pharmacy transactional data nationally and enhance billing policies and practices.
Performing day-to-day pharmacy billing operations, month-end reports/billing reports, reviewing and submitting claims
Find and assess opportunities to perfect billing.
Perform quality audits of pharmacy billings nationally to ensure compliance with Pharmacy standards of practice, provider agreements, and billing policies.
Follow up with manufacturer, patient support programs, patients, or adjudicators on outstanding pharmacy claims.
Review margin analysis of prescriptions billed nationally to detect payor changes and reduce any margin erosion.
Extract reports from Kroll for the purposes of manufacturer billing
Ability to track and trend and use a variety of tools such as Microsoft Office or web-based tools for the purposes of reporting and tracking.
Ensure company policies and standards are at the foremost of all activities and decisions.
Troubleshooting complicated claims
Analyze reimbursement-specific data and prepare reports for upper management and clients.
Maintains correct data entries into various systems.
Manage and maintain Gross Margin Report - to track pharmacy billing errors.
Ensure prescriptions are processed and billed following internal policy third-party payer-provider agreements.
Resolve escalated customer complaints.
Work with Pharmacy Supervisors to ensure that McKesson is following all Private and Public insurance policies.
The National Billing Specialist reports to the National Billing Supervisor and performs national billing functions in a pharmacy setting. Process various claims including manual submissions to various insurance providers.
Work with the National Billing Supervisor to develop and implement IDP every year.
Applicants must have at least a Grade 12 high school diploma or equivalent
Minimum 3+ years of pharmacy Kroll billing experience with a high degree of accuracy
Understanding of provincial public and private reimbursement for all province
Ability to communicate effectively (both oral and written) with internal and external customers and stakeholders; makes good decisions based on a combination of analysis, wisdom, experience, and judgment.
Consistently acts in a professional manner and serves as a role model for other team members
Creative problem-solving skills to find solutions.
This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.