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Description
Shift: 12:30p - 9p, M-F, Rotating Saturdays
The Billing Pharmacy Technician is responsible for correct profile entry, processing, and follow-up related to the billing of resident prescriptions. Communication with community staff, resident(s), and/or POAs is of utmost importance for this role, along with researching, investigating, and staying up to date on different insurance providers.
The Billing Technician is an advocate for the residents we serve and a revenue generating function of the company – both roles are equally important. This in most cases requires an investigation mindset to research, follow-up, and ensure completion of billing tasks. Attention to detail and an inquisitive spirit is essential to success in this position.
Requirements
- Understanding of Medicare Part D, Medicaid, and Commercial insurances
- Adjudicating insurance claims and troubleshooting rejected claims
- Completing and/or following-up on prior authorization forms
- Data entry into Framework LTC and Framework ECM systems
- Providing customer service through phones, checking emails and messages to pharmacy and responding promptly and professionally
- Generating monthly statements, processing and entering payments, and reconciling third-party claims
- Analyzing pre- and post- adjudication reports for training opportunities and compliance
- Following core processes
- Is prompt and able to perform the required duties of the position on a regular, predictable basis
Qualifications
- Minimum of one year pharmacy billing experience
- 2+ years pharmacy technician experience
- High Diploma or equivalent
- Licensed, and in good standing, Illinois Pharmacy Technician
- National Pharmacy Technician Certification (PTCB or NHA)
- FrameworkLTC / FrameworkECM knowledge a plus
- Must have basic knowledge of algebra and pharmaceutical math
- Timely and accurate data entry skills
- Excellent verbal and written communication skills, establishing rapport and working with others
- Professional demeanor and appearance with excellent customer service skills
- Highly organized and attentive to detail
- Able to multi-task and work under deadlines
- Motivated, punctual and reliable team member
- Dedicated to providing exemplary customer service
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