Billing Technician

Responsibilities

• Gathering information from patients, pharmacies, and insurance companies to process claims accurately
• Verifying insurance eligibility and payer information
• Preparing and submitting clean claims to commercial insurers, Medicare Part D, and Medicaid
• Managing coordination of benefits (COB) and secondary billing processes
• Researching and resolving claim denials and reimbursement issues
• Reviewing clinical documentation for Medicare compliance
• Identifying and validating ICD-10 and HCPCS codes as appropriate
• Reconciling payer payments, adjustments, and credits
• Reviewing EOBs and following up on outstanding claims
• Supporting manufacturer reporting and reimbursement tracking
• Assisting with patient financial assistance programs and foundations
• Collaborating with pharmacy staff to ensure prescriptions are reconciled and paid prior to delivery
• Protecting patient confidentiality and maintaining HIPAA compliance
• Participating in audits and reimbursement-related projects as needed

Qualifications

We Are Looking For Someone Who Is Reliable, accountable, and highly organized
Comfortable working independently in a hybrid work setting
Able to manage multiple priorities and deadlines in a fast-paced environment
Detail-oriented with strong analytical and problem-solving skills
Professional and compassionate when communicating with patients, pharmacies, and insurance representatives
Adaptable and willing to learn in an evolving specialty pharmacy environment

Preferred Qualifications

• Retail pharmacy experience and/or medical or pharmacy billing experience
• Familiarity with Medicare, Medicaid, commercial insurance, and coordination of benefits
• Strong customer service and telephone communication skills
• Proficiency with computers, email, and office software systems