SPECIALTY PHARMACY BILLING SPECIALIST - HYBRID - MISSISSAUGA (Ontario)

SPECIALTY PHARMACY BILLING SPECIALIST - HYBRID - MISSISSAUGA (Ontario)

11 Sep
|
Green Shield Canada (GSC)
|
Ontario

11 Sep

Green Shield Canada (GSC)

Ontario

WHO WE ARE
GreenShieldis a proudly Canadian, national non-profit health care and insuranceorganization, driven by our mission of Better Health for All.We believe health care is aright, not a privilege, and we are committed to improving health outcomes,advancing health equity, and building a future where every Canadian can reachtheir full health and well-being potential.

Throughour unique integrated payer-provider ("payvider") model, we offerinsurance, administer perks, and pay claims as a ‘payer’ while offeringhealth care services such as mental health, pharmacy, telemedicine, and chronicdisease management as a ‘provider’. As a non-profit social enterprise without shareholders, we reinvest our excess earnings to directly support underserved communities. Through GreenShieldCares, we positively impacted the health and well-being of over one millionCanadians between 2020 and 2025. What’s driving us now is the commitment to measurably impact an additionalthree million Canadians by 2030 – across mental health, essential medicines,and chronic disease management – through scalable initiatives that delivermeaningful change in pursuit of our mission of Better Health for All.

AtGreenShield, our culture is where purpose meets passion and performance. Our teams work as one to delivermeaningful, measurable impact for the people and communities we serve.

THEROLE IN A NUTSHELL
Base Salary: CAD $51,383.00 - 79,261.00

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 perks 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

WHO WE'RE LOOKING FOR
We're not looking for just anyone. We’re looking for a unique individual with a big brain and a big heart who wants to help us create better health for all Canadians.

+5 years as a pharmacy assistant in Specialty Pharmacy

+3 years in bookkeeping, accounting or invoicing in a pharmacy or healthcare setting

Experience working with PSP and third party payment portals

Understanding co-pays, deductibles, and out-of-pocket costs

Understanding PSPs and the Retrobilling process

Understanding how to navigate Trillium and other public plans

Patient payment collection (following up with patients, clearly explaining co-pays / deductibles)

Claims submission & PSP Management (submitting and tracking payments, logging claim statuses and escalations, following up on delayed or denied claims)

Retro-billing and Corrections (billing discrepancies and timely reimbursement)

NICE TO HAVE

Experience with Kroll considered an asset

Experience in patient collections and third party billing

Experience working with PSP and third party payment portals

THE CULTURE
We believe a career should be meaningful. Not just ameans to earn a living. Our culture is one where everyone's voice is heard andvalued.



Because that’s what it takeso create better health for all. We dare to challenge the status quo. And we’redriven by people who have challenged theirs. We believe that yourworkplace should empower you to be the best version of yourself. That’s why we provide aplace where you can be inspired, challenged, and rewarded.

Where your growth means our growth.

Where your voice is heard and valued.

Where your work has purpose. And purpose matters.

We believe our people arecritical to our overall success. Inclusivity makes us a stronger, smarter andmore informed organization. Being intentionally inclusive of diversebackgrounds, perspectives and experiences will enhance our company culture topositively impact how we support our communities. A career at GreenShield isn’t just about personalachievements, it's about making adifference together.

Here’s to Better Health for All!

AFEW MORE DETAILS
Proficiency in English is requiredfor this position. As part of this role, you will be required to communicatewith colleagues or customers who use English as their primary language. By requiring English proficiency for thisposition, we aim to ensure that our employees can excel in their roles,collaborate, and communicate effectively, and contribute to the success of ourorganization.

GS supports diversity, equity andinclusion in our teams and communities, and we value the unique contributionsmade by all. Even if your experience doesn’t align perfectly to everyrequirement, we invite you to apply. We encourage applications fromall candidates and will accommodate needs under human rights legislationthroughout all stages of the recruitment and selection process. Please let usknow of any accommodation through [email protected]. Information received relating toaccommodation will be addressed confidentially.

Providing this information givesGS consent to use your personal information to assess your suitability forspecific positions, future opportunities or for your personnel file. Yourrésumé will be held in strict confidence and will be viewed only by theOrganization. Information may be stored outside of Canada and could be used foraggregate statistical purposes (which uses no personal identification).

AI Usage - GreenShield leverages AI to help produce Job Descriptions, and ideate on interview questions. We also leverage AI for interview transcription support.

#J-18808-Ljbffr

📌 SPECIALTY PHARMACY BILLING SPECIALIST - HYBRID - MISSISSAUGA (Ontario)
🏢 Green Shield Canada (GSC)
📍 Ontario

Reply to this offer

Impress this employer describing Your skills and abilities, fill out the form below and leave Your personal touch in the presentation letter.

Subscribe to this job alert:

Get the latest job offers by email for: specialty pharmacy billing specialist - hybrid - mississauga (ontario) / ontario

Subscribe to this job alert:

Get the latest job offers by email for: specialty pharmacy billing specialist - hybrid - mississauga (ontario) / ontario