Specialty Pharmacy Billing Specialist - Hybrid - Mississauga

GreenShield Administration provides innovative health benefit solutions for the small-mid size companies in Canada. Recognized as the leading alternative to the traditional insurance companies, in a market where small and mid-sized employers have been largely underserved GreenShield Administration sets itself apart from the competition, by using technology, creative product development and a stellar customer experience to solve problems for employers. Honeybee Benefits is our next generation benefits platform built for today’s modern workforce that empowers employers to compete better for talent. 

Scoping across all GreenShield Specialty Pharmacies, the Specialty Pharmacy Billing Specialist is a patient-facing role focused on coordinating out of pocket payments with patients and Patient Support Programs (PSPs) and updating profiles in the pharmacy software, Kroll. This role serves as a key liaison between the pharmacy, Patient Support Programs (PSPs), and third-party insurers to reconcile payments, resolve billing discrepancies, collect payments, and manage retroactive billing (retro-billing) processes. 

• Manage Specialty Pharmacies’ patient AR accounts, including following up with patients via phone calls and emails to collect outstanding amounts and provide guidance through the provincial plans and PSP Portals
• Organizing and submitting co-pay amounts to PSPs using Kroll software
• Reconciling payments received from PSPs and patients with their Kroll accounts
• Supporting the Specialty Pharmacies with Retrobilling, including assessing if/when insurance coverage is established, backdating any applicable claims through the pharmacy software within acceptable window, invoicing PSPs for medications used to bridge patient while coverage was pending
• Supporting the Specialty Pharmacies with billing optimization initiatives ensuring all claims are being submitted appropriately and efficiently