Billing Specialist

About the role

East Tennessee Pharmacy Services, a member of the Guardian family of pharmacies, is seeking a Pharmacy Technician to join our rapidly growing team in Knoxville, Tennessee.

Responsibilities

• Process customer bills and insurance claims in an accurate and timely manner.
• Assist with all daily and month-end billing functions, procedures, and reporting.
• Provide excellent customer service to patients, caregivers, medical providers, and insurance carriers.
• Research and establish patient eligibility coverage with insurance providers.
• Reverify benefit coverage criteria as needed for claims follow-up.
• Maintain and audit patient files and corresponding documentation.
• Enter and update patient/insurance information into the billing system.
• Respond to billing customer inquiries via phone or electronic communications.
• Resolve patient billing issues regarding insurance eligibility, coverage, and related benefits.
• Provide guidance and support to residents or responsible parties during open enrollment and special enrollment periods.
• Evaluate patient profiles, drug regimens, and insurance coverage to find cost-saving options.
• Manage daily census, admit, discharge, and room changes for assigned facilities.
• Process patient payments, returns, and credits.
• Transmit credit card payments as needed.
• Pursue payment from delinquent accounts and make payment arrangements.
• Organize requested audit documentation in a timely manner.
• Perform prescription claims adjudication, communicate with insurance companies, and correct/rebill claims as necessary.
• Develop knowledge and understanding of pharmacy facility billing requirements and utilize pharmacy systems to meet operational needs and regulatory requirements.
• Rotate through other departments to gain working knowledge of other department workflows.
• Follow all applicable government regulations, including HIPAA.
• Work as a collaborative team member to meet the service goals of the pharmacy.

Requirements

• TN Pharmacy Technician License & PTCB Certification.
• Rotating shifts (8:30-5:30 or 9-6), including rotating holiday and weekend coverage.

Qualifications

• High School Diploma or GED required.
• Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB).
• 1+ years of related experience.
• Advanced computer skills; pharmacy information system experience preferred.
• Ability to work independently and deliver to deadlines.
• Great attention to detail and accuracy.
• Able to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines.
• Quality-minded; motivated to seek out errors and inquire about inaccuracies.

Skills

• Work Ethic/Integrity.
• Relational.
• Strategy and Planning.
• Problem Solving.
• Team Oriented.

Benefits

What We Offer:

• Competitive pay.
• 401(k) with company match.
• Family, Health & Insurance Benefits (Full-Time employees working 30+ hours/week only).
• Medical, Dental, and Vision Health Savings Accounts and Flexible Spending Accounts.
• Company-paid Basic Life and Accidental Death & Dismemberment.
• Company-paid Long-Term Disability and optional Short-Term Disability.
• Dependent Care Flexible Spending Accounts.
• Wellbeing Employee Assistance Program (EAP).
• Guardian Angels (Employee assistance fund).
• Generous vacation benefits based on years of service.

Pay

Compensation is competitive and commensurate with experience.

Schedule

Rotating shifts (8:30-5:30 or 9-6), including rotating holiday and weekend coverage.