Pharmacy Technician - Billing Specialist

Description

As a pharmacy technician – billing specialist - you will be primarily responsible for accurate billing and adjudication of prescription orders, answering customer questions related to their pharmacy invoice, managing Accounts Receivable for all patients, calling insurance companies, and answering emails and phone calls. This position will work with Framework

LTC, Cover My Meds, SAGE, and Payrazr as the primary software systems for billing and auditing all adjudicated claims. At Medicine Express, we support all pharmacy departments as one. While your primary role will be in the billing department, you will also assist with preparing medications for patient consumption under the general supervision of a licensed pharmacist and in accordance with standard departmental procedures wherever needed.

Additionally, you will provide excellent customer service and quality of service to all patients and customers.

• Technological skills – familiarity with various technological skills such as Microsoft and Pharmacy Software highly recommended
• Strong interpersonal communication skills
• Highly organized and efficient
• Ability to identify and resolve problems
• Works independently and quietly to ensure distractions do not result in medication errors

The following duties are normal for this position. This list is not to be construed as exclusive or all inclusive. Other duties may be required and assigned.

• Performs duties assigned by a licensed pharmacist. Areas of work are checked routinely for maintenance of quality control. Work is conducted in accordance with generally accepted standards of practice following departmental procedures and policies as outlined in the department operations manual.
• Demonstrates competence in the area of regulatory compliance and ensures that the pharmacy stays in regulatory compliance with all regulatory agencies
• Reads and interprets physicians’ orders and prescriptions received in the pharmacy and transcribes the information into the pharmacy computer medication profile. Requires knowledge to adjust dosing times as pharmacy will generate MARs; prepares unit doses; and labels individual patient envelopes for dispensing to the nursing unit.
• Attends and participates in pharmacy tech meetings to exchange ideas to achieve goals of the department.
• Electronic billing of private pay, Medicare, Medicaid, and Third Party claims utilizing pharmacy software.
• Ensure accuracy of adjudicated claims by establishing and maintain auditing procedures.
• Manages Prior Authorizations required from Third Party Insurance
• Manages electronic claims log for rejected claims and supervises scheduled claims daily
• Follow-up with payers, patients and other appropriate parties to collect open billings in a timely manner and to ensure compliance with billing regulations.
• Follows company policy on billing and auditing procedures.
• Processes credit card transactions for charge accounts monthly
• Generate and transmit refill reports monthly
• Assist pharmacy manager with development and implementation of Therapeutic Interchange processes
• Keeps procedures up-to-date in pharmacy tech manual to train new personnel and to have quick reference to specific jobs so they are performed according to the policies of the department.
• Assists pharmacy staff with checking in orders, putting orders away and filing associated paperwork as needed.
• Continues to educate by attending drug in-services and keeping up with policy changes.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Active and undisciplined Pharmacy Technician Registration in the State of Illinois
• PTCB or NHA Pharmacy Technician Certification required
• Associate degree or degree from technical program, OR High school diploma and 1-2 years of experience as a Pharmacy Technician, or…