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