For over 50 years, the HealthDirect team has been dedicated to the unique pharmacy needs of individuals residing in Long-Term Care (LTC) facilities such as nursing homes and assisted living facilities, as well as correctional facilities and group homes.”.  On a daily basis our team provides prescription medications, over-the-counter products, clinical consulting services, and specialty pharmacy services to more than 50,000 residents. 

HealthDirect is a division of KPH Healthcare Services, a billion dollar, 100% employee owned provider of pharmaceutical and healthcare services. KPH is comprised of four divisions – Kinney Drugs, ProAct Inc., HealthDirect and Noble Health Services.  The family of KPH Healthcare Services began with Kinney Drugs retail in 1903.  All KPH family company values stem from Kinney’s long-standing commitment to trust and community-minded health solutions.  

As a team, HealthDirect has achieved significant growth. Over the past 6 years we have grown from four pharmacies in two states to 20 pharmacies across eight states.  Our team has grown to over 900 employees and we are looking to add another – possibly you!

Scope of Responsibilities: Works in-person/remotely under supervision of Billing Administrator.  Follows standard procedures to accomplish assigned tasks.  Work within multiple HealthDirect facilities as directed by the Billing Administrator.  Responsible for the accurate rebilling and reporting of all NetRx details to the Billing Administrator as well as identifying, researching and rectifying all billing related matters that may be assigned.

Job Summary: Responsible for all aspects of NetRx and special projects as assigned.  Other responsibilities will include the duties listed below.

Job Duties:

• Responsible for all NetRx Reports
• Face-sheet and census entry to ensure accurate billing.
• Verifying primary and secondary insurance coverage on residents.
• Provide customer service and problem resolution to facilities and residents.
• Account reconciliation and account refund requests
• Complex account reconciliation
• Account adjustments, bad debt processing
• Third party, Medicare, Managed Care, and private billing, claim corrections and follow-up
• Track and re-bill pending Medicaid accounts
• Re-bill claims as needed
• Identify pattern problems (improper patient demographic data entered, Insurance information not entered, etc.). Initiate corrective action plan and notify management.
• Maintain accurate records of all work performed on an account to include letters, telephone conversations, charges payments, etc.
• Recognize and rectify any errors made within an account
• Set up Lawson accounts for facility and private pay
• Month-end closing process within the scheduled deadline.
• Assist in special projects as required
• Works with minimal supervision
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Job Skill Requirements:

• Strong communication skills
• Outstanding customer service skills
• Ability to work independently
• Excellent organization skills
• Proficient with multiple remote technology
• Ability to multitask and prioritize
• Broad knowledge of medications and physician orders
• General computer and keyboarding skills
• Strong leadership skills
• Successful completion of a pre-employment and/or random drug screening test

Required Training:

• HIPPA Privacy Course
• HIPPA Security Course
• Fraud, Waste, and Abuse Course
• All Other Training as Required

Behavioral Traits Required:

• Cooperation: Must work harmoniously and effectively with fellow employees, supervisors and others you are in contact with
• Initiative: Must work within supervision guidelines and assume additional responsibilities
• Flexibility: Must be willing to work variable work schedules, nights and weekends, assist others as requested and available, and be willing to perform all assigned work
• Adaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiences
• Involvement: Must enjoy the demands of the job and work with interest and enthusiasm
• Customer Service: Must provide appropriate customer service (for Kinney customers, fellow employees and business partners), listen attentively to their needs and respond appropriately
• Safety: Must take care of equipment and employ good safety habits
• Leadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teams

Attendance Requirements:

• Must be available, and on-time for scheduled work shifts. (remotely or on-site)
• Must be able to work nights and weekends as required.

Educational Requirements:

Minimum: 

• High School Diploma or GED
• Two years of service
• AS Degree or Higher in Business Administration or related field

Experience: 

• 2 years experience as a pharmacy customer service technician for HealthDirect required
• Previously demonstrated top 5% data entry performance metrics

Required (Vermont Employees):

• Registered with the State of Vermont as a Pharmacy Technician

Special Conditions of Employment:

• Criminal background check and/or drug test
• Initial and continuous exclusion and sanction/disciplinary monitoring
• Demonstrate HIPAA compliant workspace at home
• Demonstrate ability to hit and maintain key productivity measures as determined by Regional Manager of Operations