Copay Assistance Billing Clerk

AmeriPharma

Posted 3 months ago

Full Time

Laguna Hills, California

In Person

Smart Summary

Responsibilities

The role involves preparing and submitting CMS-1500 claim forms to copay assistance programs and payors. It also requires tracking payments, documenting account activity, and collaborating with revenue cycle teams to ensure continuity of patient care.

Qualifications

You have a high school diploma or equivalent and at least one year of experience in administrative, medical billing, pharmacy billing, or healthcare reimbursement. You are proficient with Microsoft Office applications and possess strong attention to detail, organizational skills, and the ability to manage multiple tasks in a fast-paced environment.

Must Have Skills for ATS

CMS-1500

Microsoft Office

Job Description

About AmeriPharma

AmeriPharma is a highly rated closed-door pharmacy making a positive impact on the lives of our patients every day. Our family of brands provides long-term pharmacy care at home. That includes nursing services with CorsanaCare, AmeriPharma Infusion Centers, AmeriPharma Specialty Care, and MedBox, a pharmacy made for seniors.

We're looking for candidates who want to grow with us as our customer demand grows. We're constantly improving the way we work, investing in innovative technology for our future, and striving to modernize pharmacy operations – a rare thing in our industry.  If you want to grow your career in a supportive and transparent environment where people are respected, customers come first, and effort is recognized, this might be the role for you.

(Remote work is not an option at this time.)

AmeriPharma’s Benefits

  • Full benefits package including medical, dental, vision, life that fits your lifestyle and goals
  • Great pay and general compensation structures
  • Employee assistance program to assist with mental health, legal questions, financial counseling etc.
  • Comprehensive PTO and sick leave options
  • 401k program
  • Plenty of opportunities for growth and advancement
  • Company sponsored outings and team-building events
  • Casual Fridays 


Position Summary
The Copay Card Billing Clerk supports the Specialty Pharmacy and Home Infusion Financial Assistance Dept by assisting with administrative and reimbursement-related functions associated with manufacturer copay assistance and foundational programs claims processing. This role works closely with the Revenue Cycle Data & Process Specialist and Copay Assistance teams to ensure timely claim submission, payment follow-up, and accurate documentation to support reimbursement operations and continuity of patient care.

Job Details

Location:  In-person in Laguna Hills, CA

Schedule:  M-F 8:00AM - 4:30PM

Essential Duties and Responsibilities
Generate and prepare CMS-1500 claim forms for submission to copay assistance programs, payors, and other reimbursement entities. 
Contact payors, copay card vendors, and reimbursement support programs to obtain claim, payment, and denial status updates. 
Document account activity, claim status, and follow-up actions accurately within applicable systems. 
Assist with payment tracking, reconciliation, and identifying outstanding balances or unresolved claims. 
Support copay billing operations related to specialty pharmacy and home infusion services. 
Maintain organized records and ensure supporting documentation is complete and compliant. 
Collaborate with Revenue Cycle teams to resolve billing-related issues. 
Assist with administrative tasks including faxing, scanning, data entry, correspondence, and reporting as assigned. 
Escalate reimbursement concerns, trends, or unresolved issues to the FA leadership team appropriately. 
Maintain confidentiality and comply with HIPAA and all applicable regulatory requirements. 
Perform additional duties and special projects as assigned. 


Qualifications
High school diploma or equivalent required. 
Minimum 1 year of administrative, medical billing, pharmacy billing, or healthcare reimbursement experience preferred. 
Experience in specialty pharmacy, home infusion, medical billing, or copay assistance programs strongly preferred. 
Knowledge of CMS-1500 claim forms, insurance terminology, and reimbursement processes preferred. 
Strong attention to detail and organizational skills. 
Ability to manage multiple tasks and meet deadlines in a fast-paced environment. 
Effective verbal and written communication skills. 
Proficient in Microsoft Office applications and basic data entry functions. 
Ability to work independently and collaboratively within a team environment. 

Physical Requirements

The physical requirements for this role includes constant sedentary work that primarily involves sitting/standing; ability to hear, see and speak; type and write, repeating motions that may include the wrists, hands and/or fingers.  Must be physically able to operate a computer and other office productivity machinery (i.e., a calculator, copy machine, printer); constantly communicate with colleagues and clients including via telephone and email. Must be able to lift up to 15 pounds at times. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EEO Statement 

The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.

AmeriPharma

A DIFFERENT KIND OF PHARMACY AmeriPharma is a highly rated closed-door pharmacy that offers tailored care to patients with complex needs. Our family of brands provides long-term pharmacy care at home. That includes nursing services with CorsanaCare, AmeriPharma Infusion Centers, AmeriPharma Specialty Care, and MedBox, a pharmacy made for seniors. We are not open to the public for walk-in and retail pharmacy services. Instead, we focus on efficient, high-volume production to serve our large volume of patients. Our innovative pharmacy model helps our patients with both their clinical and economic outcomes. A CHANCE TO MAKE A POSITIVE CHANGE We make a positive impact on the lives of our patients every day – whether by providing them with life-saving medication, empowering them to live independently, or working with them to find medication coverage solutions. Compassion is our legacy. AmeriPharma is looking for candidates who want to grow with us as our customer demand grows. With our company culture, everyone gets to contribute ideas and see the impact of their work. That's why we invest in employee career development through our emerging leadership program, educational conferences, and more. Agility is our strength. We are constantly finding ways to improve the way we work, the care we bring to our patients, and the efficiency of our workflows. We've also taken a strong stance on modernizing pharmacy operations – something that's rare in an industry known for sticking to tradition. That includes investing in AI integrations and an engineering team that constantly improves the proprietary software that powers our pharmacy. Innovation in pharmacy care is our future.
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