Specialty Billing Technician
- Submit timely, accurate invoices to payer for products and services provided.
- Correctly determine quantities and prices for products and services billed.
- Verify services and products are correctly authorized and required documentation is on file.
- Ensure all Medicare documentation is received from the medical provider and submitted to Danville.
- Review reports to maximize generic substitution opportunities.
- Manage and collect patient balances prior to prescription dispensing, or in accordance with company policy.
- Ensure all required documentation for billing is completed and accurate prior to claim submission (i.e., medical claims billing).
- Process reimbursement checks/payment in accordance with policy.
- Review price modify logs and ensure there are corresponding SDL (submit direct link) claims.
- Review, research and resolve all third party chargebacks in a timely manner.
- Assist with any third party audits, in accordance with company policy.
- Process and file all SDL (submit direct link) claims in accordance with company policy.
- Processing of prescription exceptions including prior authorizations, triaging of referrals to other Walgreens locations, and proactively identifying copay assistance opportunities.
- Responsible for proactive communication to patients and providers regarding referral/prescription status.
- Responsible for maintaining a deep understanding of and assisting patients with assistance programs enrollment, such as Chronic Disease Fund, confirming patient eligibility and all required reporting and documentation.
- Handles telephone calls that do not require personal attention of the pharmacist, including those to physicians and third party payers.
- Maintains subject matter expertise pertaining to all external billing practices including but not limited to third party adjudications, prior authorization, and patient financial assistance programs in order to coach pharmacy technicians and other support staff.
- High School Diploma or equivalent.
- Pharmacy Technician license, in states where required.
- Maintains PTCB or ExCPT certification through the designated PTCB or ExCPT training program and/or state required certification/registration.
- Experience communicating both verbally (on phone, one-on-one, to groups) and in writing (emails, letters, reports, presentations) to various audiences (work group, team, company management, prospective acquisitions, external clients).
- Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
- Prefer six months of experience in a retail environment.
- Prefer to have prior work experience with Walgreens.
- Experience in processes related to submitting medical claims, including but not limited to Medicare submission, knowledgeable in EOB (explanation of benefits), remittance advice and adherence to timely filing limits.
- Experience entering data into databases (e.g., MS Excel).
Salary Range: $22 - $29 / Hourly
Recommended Jobs
Sales Floor Manager
Job Description Job Description An automotive sales floor manager is responsible for overseeing the day-to-day operations of an automotive dealership's sales floor. This includes managing a team …
Banquet Server, Charlotte Convention Center, CRVA
Job Description Job Description Who We Are The CRVA works to deliver experiences that uniquely enrich the lives of our visitors and residents. Through leadership in destination development,…
Outside Sales - Charleston, SC
Job Description Job Description Job Description: Outside Sales Representative Role Summary: Morrison Millwork specializes in the distribution and retail sales of premium windows and…
Assistant Director of Project Management
Job Description Job Description Assistant Director of Project Management About the Role Allen Industries is hiring an Assistant Director of Project Management to lead day-to-day executi…
SAP Integration Engineer
Bright Vision Technologies is a technology consulting and software development company delivering cloud, AI, data, and enterprise solutions across the United States.This is a fantastic opportunity to …
Director, Bid
Come Build Your Career at Aecon! As a North American leader in infrastructure development, Aecon is safely and sustainably building what matters for future generations to thrive! We lead some…
Engineer Maintenance (U)
POSITION SUMMARY Respond and attend to guest repair requests. Fix minor plumbing problems such as unclogging drains, plunging toilets, and repairing leaky spigots and faucets. Perform miscella…
Plumbing Service Technician (Zebulon, Elon & Surrounding Areas)
Job Description Job Description Job Summary: Plans and coordinates activities concerned with installing equipment, investigating and resolving customer reports of technical problems with equip…
Reconstructive Service Technician
Job Title : Reconstructive Service Technician Job Location : Charlotte, NC Operating Company : AIR Carolinas FLSA Status : Exempt Pay Range : $20-25/hr About : AIR Caroli…