Pharmacy Billing Technician

MAC Rx of Missouri, a growing long term care pharmacy, is seeking a Billing Technician to join our team! The successful candidate will have intimate knowledge of federal and state pharmacy laws and guidelines, be a problem solver, and is able to work well in a team environment. The primary purpose of this position is to ensure that all claims are paid and posted in a timely manner to avoid disruption of pharmacy run times, providing valuable assistance with our daily prescription orders and ultimately servicing our residents.

Adjudication Responsibilities include:

· Knowledge of Third Party Billing

· Knowledge of FFS Billing

· Knowledge of payor verification

· Familiarity of dual coverage, MCR D and commercial plans pertaining to long term care

· Familiarity with prior authorization process

· Assists with all customer billing inquires in a courteous and professional manner

· Able to work at a quick pace

· Understand and work with residents on account balances

· Follow all applicable government regulations including HIPAA

Prior Authorization Responsibilities include:

· Answer calls from nursing homes and physicians using exemplary customer service

· Work with departments and insurance companies to obtain necessary pre-certification for services ordered or scheduled by our facilities

· Input prior authorization data into Framework LTC and other spreadsheets to ensure accurate billing

· Maintain a high level of understanding of insurance companies and billing authorization requirements

· Initiate and follow up on prior authorizations for designated facilities

· Responsible for working retro prior authorization batches for designated facilities

Census Responsibilities include:

· Enter patient admission information in a timely and accurate manner

· Review patient face sheets for completeness

· Input billing information, not limited to insurance, Medicare Part B, Medicaid and Medicaid pending

· Manage readmission data

· Process and maintain patient census and billing information on a daily basis

· Process and Maintain the Medicare A log from facilities to ensure accurate billing

· Process patient discharge report weekly

· Process room and bed report weekly

Qualifications and Requirements:

· Strong attention to detail required

· Friendly and professional demeanor

· Intimate knowledge of federal and state pharmacy laws and guidelines

· Ability to follow direction and prioritize tasks

· Ability to maintain composure on phone when handling customer calls

· Excellent communication and organization skills

· Problem solver

· Ability to work as a team player in a fast-paced environment

· Minimum of 2 years pharmacy experience required, long term care pharmacy preferred

· Must hold a Missouri Pharmacy Technician license or certification

· Ability to be flexible with work schedule, including working weekends and holidays

We are seeking a full-time hire at this time. The full time position will be comprised of a 40 hour work week and will qualify for health, dental, and vision insurance along with short and long term disability, life insurance, access to a 401(k) as well as a generous PTO plan.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Pharmacy Technician: 1 year (Preferred)

License/Certification:

• Pharmacy Technician License (Preferred)

Work Location: In person