Company Overview
Our Pharmacy is a long-term care pharmacy dedicated to providing comprehensive pharmaceutical services tailored to the needs of our clients. We prioritize accuracy, efficiency, and exceptional customer service in all aspects of our operations.
Overview
We are seeking a detail-oriented and motivated Pharmacy Technician specializing in insurance billing processing. The successful candidate will play a vital role in managing healthcare claims, ensuring accurate billing, and supporting the overall financial operations of our pharmacy. This position offers an opportunity to work within a dynamic healthcare environment, utilizing your medical coding expertise and customer service skills to enhance patient care and operational efficiency.
Duties
- Process insurance claims accurately using billing software and electronic health record (EHR) systems, ensuring compliance with healthcare regulations.
- Submit prescription claims electronically to insurance plans and PBMs (adjudication)
- Troubleshoot and resolve claim rejections (prior authorizations, refill-too-soon, DUR conflicts, invalid NDCs, coverage issues)classifications, to support billing accuracy.
- Manage medical collections by following up on unpaid claims and resolving billing discrepancies promptly.
- Collaborate with healthcare providers and insurance companies to resolve claim denials or issues efficiently.
- Verify patient insurance eligibility and coordinate benefits when a patient has multiple plans
- Process prior authorizations and coordinate with prescribers and payers to get approvals
- Stay updated on health insurance policies, coding changes, and industry best practices to ensure compliance.
- Provide excellent customer service by addressing patient inquiries related to billing and insurance processes professionally.
- Maintain accurate billing records and ensure compliance with HIPAA and payer rules
Experience
- Proven experience in medical billing or coding within a healthcare or pharmacy setting.
- Experience working with billing softwares
- Knowledge of healthcare claims management processes and medical collection procedures.
- Strong understanding of health insurance policies, medical terminology, and medical records management.
- Prior experience in a medical office environment with exposure to pharmacy or long-term care settings is preferred.
- Excellent organizational skills combined with effective communication abilities to coordinate with team members and external partners.
Join our team to contribute your expertise in pharmacy billing operations while supporting high-quality patient care through precise financial management!
Pay: $23.00 - $32.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Education:
- High school or equivalent (Preferred)
License/Certification:
- Pharmacy Technician License (Preferred)
Work Location: In person
