LTC Billing Technician

GRX Holdings, LLC is a fast-growing, family-oriented group of independent pharmacies seeking a Full-Time Billing Technician to work at our Medicap Long Term Care Pharmacy in Iowa City. This is an on-site position.

About the role

The Long-Term Care Billing Pharmacy Technician submits invoices for prescription claims to insurance companies and invoices private pay amounts to patients for a variety of billing cycles. This position must meet tight deadlines and be able to complete a variety of administrative tasks, including posting payments to billing accounts.

Responsibilities

• Prepare and submit claims to various insurance companies for prescription sales using FrameworksLTC software.
• Answer questions from long-term care facilities (“LTC”), patients, pharmacy personnel, and insurance companies.
• Manage the set-up and maintenance of resident’s files in accordance with company standards.
• Investigate and resolve patient billing questions.
• Resolve patient complaints appropriately.
• Prepare, review, and distribute patient statements to LTC Facilities within required deadlines.
• Maintain a working relationship with assigned LTC Facilities and Group Homes to ensure resident’s billing status is correct.
• Obtain, track, and follow-up on prior approvals for all medications or items as required by payers.
• Process returns and credits of medications.
• Organize documents for insurance audits.
• Review resident face sheets and make corrections if needed.
• Contact insurance companies for benefit investigation and coverage eligibility.
• Assist with billing of items used from emergency kits.
• Monitor, maintain, and ensure adequate office supply inventory.
• Perform various collection functions, including contacting patients by phone, correcting and resubmitting claims to third-party payers.
• Process payments from insurance companies, posting to patient and third-party accounts.
• Continually look for process improvements to increase efficiencies in work performed.
• Adhere to all HIPAA guidelines/regulations.
• Perform additional duties as assigned by Supervisor.

Requirements

• High School Diploma.
• 2 years of billing experience required.
• Minimum 2 years’ experience working in a professional office environment.
• Knowledge of medical billing/collection practices.
• Knowledge of Medicare, Medicaid, and third-party billing requirements.
• Ability to operate a computer and basic office equipment.
• Knowledge of business office procedures.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Skill in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand, and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, employees, and the public.
• Highly organized and detail-oriented.
• Proficient in Microsoft Office products (Word, Excel).
• Ability to meet deadlines.
• Ability to manage competing priorities in a professional manner.
• Ability to think “on your feet.”

Preferred Qualifications

• Knowledge of FrameworksLTC software (preferred but not required).
• Pharmacy Technician experience (preferred).
• 1 year of pharmacy experience (preferred).
• 1 year of long-term care pharmacy experience (preferred).
• 1 year of billing experience (required).

Benefits

• Medical, dental, and vision benefits for full-time positions.
• 401k with company match.
• Employee discount.
• Other benefits available.

Pay

Highly competitive pay rate commensurate with experience.