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Direct Bill Processor Jobs in Virginia (NOW HIRING)

Cooley

Director of IP Operations

Reston, VA · On-site

Manage fixed fee and flat fee billing structure, analysis of costs, competitive data, and ... Review and process time logs as needed (pertains to non-exempt direct reports) * Participate in ...

Cooley LLP

Director of IP Operations

Reston, VA

Manage fixed fee and flat fee billing structure, analysis of costs, competitive data, and ... Review and process time logs as needed (pertains to non-exempt direct reports) * Participate in ...

Deloitte

Billing Services Associate

Richmond, VA · On-site

$17.75 - $22.50/hr

... direct rate adjustments * Collaborate with other Finance and Contracts professionals providing ... processes, and functions. Qualifications Required: * Bachelor's degree in accounting, business ...

Westin Washington Dulles Airport

Night Auditor

Herndon, VA · On-site

$15.50 - $20.50/hr

Completes all credit card transmittal's, direct bills, and no show billings for the day. Prepares ... Receives and processes telephone and walk-in reservations accurately ensuring guest satisfaction.

Moore DM Group LLC

Account Manager, Direct Mail

Vienna, VA · On-site +1

$65K - $80K/yr

Description Account Manager, Direct Mail, Remote Work Opportunity At Production Solutions , we ... billing, and postage reconciliations. • Working knowledge of printing methods, data processing ...

Marriott North Charleston

Night Auditor

Herndon, VA · On-site

$15.50 - $20.50/hr

Completes all credit card transmittal's, direct bills, and no show billings for the day. Prepares ... Receives and processes telephone and walk-in reservations accurately ensuring guest satisfaction.

Deloitte

Billing Services Specialist

Richmond, VA · On-site

$19 - $25.75/hr

... indirect and direct rate adjustments * Analyze project costs to ascertain allowability and ... processes, and functions. Qualifications Required: * Bachelor's degree in accounting, business ...

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All JobsDirect Bill Processor JobsDirect Bill Processor Jobs in Virginia

Direct Bill Processor information

What is a direct bill processor?

Direct Bill Processors are administrative professionals responsible for managing and processing direct billing transactions, typically within insurance companies or financial institutions. Their main duties include verifying policyholder information, generating invoices, applying payments, reconciling accounts, and resolving discrepancies related to direct bill accounts. They play a crucial role in ensuring accurate and timely billing, which helps maintain positive client relationships and smooth financial operations. Direct Bill Processors must have strong attention to detail, organizational skills, and familiarity with billing software and procedures.

What are the key skills and qualifications needed to thrive as a direct bill processor, and why are they important?

To thrive as a Direct Bill Processor, you need strong attention to detail, proficiency in billing procedures, and a solid understanding of accounting principles, often requiring a high school diploma or equivalent. Familiarity with billing software, spreadsheets, and insurance or financial management systems is typically expected. Effective communication, organizational skills, and problem-solving abilities help you excel in managing client accounts and resolving discrepancies. These competencies ensure accurate billing, timely payments, and smooth financial operations within the organization.

What are some common challenges faced by direct bill processors, and how can they be addressed?

Direct Bill Processors often encounter challenges such as managing high volumes of transactions while ensuring accuracy and timeliness. Discrepancies between billing statements and payments can require careful investigation and communication with clients or insurance carriers. Staying organized, maintaining attention to detail, and utilizing workflow management tools can help overcome these challenges. Collaboration with accounting teams and clear documentation are also key to resolving issues efficiently and maintaining smooth operations.

What is the difference between Direct Bill Processor vs Insurance Claims Processor?

AspectDirect Bill ProcessorInsurance Claims Processor
CredentialsHigh school diploma or equivalent; some roles may require insurance or billing certificationsHigh school diploma or equivalent; certifications like CPC or CCA are common
Work EnvironmentOffice setting, handling billing for healthcare providersOffice setting, reviewing and processing insurance claims
Employer & IndustryHealthcare providers, billing companiesInsurance companies, healthcare organizations
Search & Comparison IntentOften compared for billing roles in healthcareRelated to claims processing and insurance reimbursement

Both roles involve healthcare billing, but a Direct Bill Processor primarily manages billing directly with patients or providers, while an Insurance Claims Processor handles insurance claim submissions and reimbursements. Understanding these differences helps job seekers find the right position aligned with their skills and career goals.

Pharmacy Billing Representative-Remote

Roanoke, VA • Remote

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$17.50 - $22.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 hours ago

Job description

Build Your Career with Us!

Competitive Pay Stable Schedules Career Growth Multiple Shifts Available

SpecialtyRx is a fast-growing Long-Term Care pharmacy dedicated to providing personalized, high-quality pharmaceutical services to long-term care facilities and assisted living communities.

We are currently seeking a Third-Party Rejections Specialist to join our team. This role is focused specifically on hands-on third-party insurance rejection experience. If you have direct experience researching, resolving, and processing pharmacy insurance rejections, we want to hear from you!

Candidates must reside in Ohio, Virginia, or Kentucky.

What You'll Do

  • Perform duties and responsibilities assigned by the Billing Supervisor.
  • Research and verify patient eligibility and insurance coverage with state and private insurance providers.
  • Research, analyze, and resolve third-party insurance rejections in accordance with daily rejection reports.
  • Maintain and update patient billing, insurance, and coverage information in the system.
  • Submit and follow up on prior authorizations for state insurance programs.
  • Communicate directly with insurance companies regarding rejections, overrides, eligibility issues, coverage changes, and claim updates.
  • Investigate and resolve pending billing and insurance issues.
  • Work with client facility staff and other applicable healthcare organizations and agencies, including PDP/Medicare, CMS, NJM, and NYM, when necessary.
  • Maintain accurate documentation and ensure billing information is current and complete.
  • Work independently while collaborating with the billing team to meet daily goals and deadlines.
  • Handle multiple priorities in a fast-paced environment while maintaining accuracy and attention to detail.

Qualifications

Who We're Looking For

We're looking for detail-oriented professionals who understand how to work through third-party pharmacy claim rejections and are comfortable communicating with insurance providers to identify and resolve coverage and billing issues.

If your background is primarily in medical billing or medical coding, this position may not be the right fit. We are specifically seeking candidates with direct third-party pharmacy rejection experience.

Required:

  • High school diploma or equivalent.
  • Direct, hands-on experience working with third-party pharmacy insurance rejections is required.
  • Experience must be in actual third-party rejection processing/resolution.
  • Strong computer skills and ability to learn and navigate multiple systems.
  • Excellent attention to detail and problem-solving skills.
  • Professional and courteous telephone communication skills.
  • Ability to work independently and as part of a team.
  • Ability to multitask and prioritize work in a fast-paced environment.
  • Strong organizational skills and follow-through.

Preferred:

  • Previous pharmacy experience.
  • Long-Term Care Pharmacy experience.
  • Experience with New York pharmacy billing claims.
  • Frameworks/ECM experience.
  • Experience working directly with insurance providers to resolve pharmacy claim rejections.

Schedule

We are hiring for multiple shifts!

Candidates must have weekend availability. Flexibility to work evenings and/or overnight shifts is strongly preferred.

Available shifts may include:

  • 8:00 AM - 4:00 PM
  • 9:00 AM - 5:00 PM
  • 11:00 AM - 7:00 PM
  • 12:00 PM - 8:00 PM
  • 3:00 PM - 11:00 PM
  • 4:00 PM - 12:00 AM

What We Offer

  • Competitive pay based on experience.
  • Stable and consistent scheduling.
  • Opportunities for career growth.
  • Health, dental, and vision insurance.
  • Group life insurance and short-term disability.
  • Paid time off and paid holidays.
  • 401(k) with company match.
  • Paid training and development opportunities.
  • Collaborative and supportive work environment.

Ready to Join the SpecialtyRx Team?

Apply today through our careers portal:

Apply Here - SpecialtyRx Careers

We look forward to reviewing your application and connecting with qualified candidates to schedule an interview.

EEO Statement

SpecialtyRx, Inc. is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation, gender identity, or any other status protected by federal, state, or local law.

EO/Minorities/Females/Disabled/Veterans

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