4338 Payment Specialist

We at PQS by Innovaccer believe that improving patient health outcomes starts with quality measurement. With our flagship technology platform EQUIPP® as the foundation, we connect payers and providers who value measurement and share our mission to contribute to a healthier world.

PQS by Innovaccer connects major healthcare payers with 95% of pharmacies to support quality improvement for over 60 million patients. We support providers and payers with insights to understand quality improvement opportunities. We care about elevating the role of pharmacy to make a difference in a patient’s quality of life.

As Payment Specialist, you will report to the Director, Clinical Transformation and work closely with the Payer Account Management and Accounting teams to ensure accurate, timely invoicing and payment distribution across PQS Enhanced Services programs.

You will be responsible for end-to-end payment operations—from invoice review and revenue tracking to disbursement coordination with PSAOs, chain pharmacies, and independent pharmacy organizations.

Requirements

Invoice Review & Coordination

•          Collaborate with Payer Account Managers to review monthly invoices for Enhanced Services programs for accuracy

•          Collaborate with Payer Account Managers to review invoicing monthly, quarterly and bi-annually.

•          Send finalized pharmacy and PQS invoice details to the accounting department for each payer on a monthly basis.

•          Work with the payer team to ensure new program invoices are generated as programs go live.

Payment Processing & Distribution

•          Coordinate on Payment process with Finance and Accounting teams including the following tasks:

●        After payments are received, verify independent pharmacy affiliations to ensure the most current organization is paid.

●        Send the accounting department revised payment details for disbursement at the end of each month.

●        Send a monthly payment breakdown by organization to the appropriate enterprise pharmacy contacts.

●        Collect W-9 and EFT information from organizations and follow up on outstanding items as needed.

•          Follow up with accounting and payer account managers on in-progress and delayed invoice payments.

Revenue Tracking & Pharmacy Support

•          Track PQS revenue for Enhanced Services payments.

•          Track payments by payee to support timely and accurate disbursement to pharmacies.

•          Answer all payment-related tickets and inquiries from organizations and pharmacies.

•          Work collaboratively with all PQS staff and its parent companies to ensure that PQS’ mission and plans are carried out successfully.

You have…

•          A Bachelor’s degree in Accounting, Finance, Business Administration, or a related field.

•          2+ years of experience in billing, accounts receivable, payment operations, or financial coordination—preferably in a healthcare or healthcare technology environment.

•          Strong organizational skills with the ability to manage multiple recurring deadlines simultaneously.

•          Proficiency with Microsoft Excel and data management tools; experience with healthcare provider data is a plus.

•          Excellent communication skills and the ability to build and maintain professional relationships across internal teams and external partners.

•          Excellent work ethic, including the ability to achieve results with minimal supervision.

•          Ability to observe high levels of business protocol and to maintain confidentiality.

•          Must be able to work under pressure and meet sensitive, recurring timelines.

Outstanding candidates will have…

•          Prior experience with payment operations, billing, or payer invoicing in a healthcare environment.

•          Familiarity with pharmacy industry identifiers including NPI, NCPDP, and Tax ID numbers

•          Experience with EFT and ACH disbursement processes.

You are the right person for PQS if you…

•          Have an entrepreneurship mindset.

•          Are innovative in your approach to work.

•          Are nimble in techniques to meet the needs of the business.

•          Have commitment to delivering excellent services.

•          Fulfill role and responsibilities at the highest ethical standards and maintain a professional image for PQS.

Benefits

• Health Care Plan (Medical, Dental & Vision)
• Retirement Plan (401k, IRA)
• Life Insurance (Basic, Voluntary & AD&D)
• Paid Time Off (Vacation, Sick & Public Holidays)
• Family Leave (Maternity, Paternity)
• Short Term & Long Term Disability
• Training & Development
• Work From Home
• Free Food & Snacks
• Wellness Resources
• Stock Option Plan