Role Description

The Pharmacy Billing Technician is responsible for managing and reconciling the daily census of assigned clients. In addition, the Pharmacy Billing Technician is responsible for processing timely and accurate bills to assigned clients.

• Reconcile client census for assigned clients on a weekly basis.
• Verify correct patient/customer set up for monthly billing including:
  • Validating data on patient/customer is correct;
  • Method of payment is included and correct;
  • Medicare days are entered;
  • Invoice group is reflected accurately.
• Ascertain updates on any payer source changes are made timely and accurately.
• Process unit dose rejections in coordination with Third Party Cycle Billing Specialist.
• Ensure assigned clients are billed accurately and timely.
• Review unbilled claims for proper payor.
• Skilled nursing care clients are expected to be billed by the third (3rd) business day of each month.
• Private pay patients/customers are expected to be billed by the sixth (6th) business day of each month and no later than the tenth (10th) business day of each month.
• Assist Phone Triage Technician and Accounts Receivable Analyst with:
  • Providing customer notes and answers to questions asked by client/customer and/or family members;
  • Monitoring payer status of clients who are deemed to be Medicaid pending;
  • Once Medicaid eligibility is determined, rebilling client appropriately;
  • Provide Best Available Evidence (“BAE”) on Medicaid eligible patients/customers when needed.
• Assist with Third Party Audits, as requested.
• Assist with Hospice billing, as requested.
• Any and all other duties as assigned.

Qualifications

• High school diploma or equivalent.
• Long-term care pharmacy billing experience, minimum one (1) year preferred.
• Detail oriented with effective time management skills.
• Software skills:
  • Experience with billing and accounting software for managing accounts, processing payments, and reconciling reports;
  • Advanced knowledge of Microsoft products.

Benefits

• Competitive pay, aligned with market guidelines.
• Full Benefits Package, including very generous paid time off plans.
• Professional liability coverage.
• 100% employer-funded ESOP retirement plan.
• 401(k) and Roth(k) plans.
• Continuing education.
• Credit union membership.