Pharmacy Technician - Billing

About the role

With one of the nation’s largest, most innovative long-term care pharmacy services provider, Saliba’s Extended Care Pharmacy, a member of the Guardian family of pharmacies, there is no limit to the growth of your career. Located in Phoenix, Arizona, we are reimagining medication management and transforming care.

Responsibilities

• Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities.
• Reverify benefit coverage criteria as needed for claims follow up.
• Accurately enters and/or updates patient/insurance information into billing system.
• Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance.
• Accurately enter patient information into the pharmacy system.
• Provide assistance and timely response to all billing customer inquiries via phone or electronic communications.
• Research and resolve patient billing issues regarding insurance eligibility, coverage, and related benefits.
• Proactively review patient profiles, drug regimens and insurance coverage to evaluate options to save resident money.
• Responsible for completion of daily census, admit, discharge, and room changes for the facilities assigned.
• Process patient payments, returns, and credits. Transmit individual credit card payments as needed.
• May pursue payment from delinquent accounts and make payment arrangements.
• Research, identify and organize requested audit documentation in timely manner.
• Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed.
• Make corrections as needed and rebill claims as necessary.
• Develop knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances).
• Develop proficiency in the utilization of pharmacy information systems to meet operational needs and regulatory requirements.
• This includes using pharmacy systems to process prior authorizations, resolve rejections, produce various reports as necessary, and complete billing functions.
• Rotate through other departments to gain working/functional 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

• Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy.
• Relational – ability to build relationships with business unit management and become “trusted advisor.”
• Strategy and Planning – ability to think ahead, plan and manage time efficiently.
• Problem Solving – ability to analyze causes and solve problems at functional level.
• Team Oriented – ability to work effectively and collaboratively with all team members.

Qualifications

• High School Diploma or GED required.
• Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required (pharmacy specific).
• 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.
• Ability 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

• Advanced computer skills; pharmacy information system experience preferred.
• Ability to work independently and deliver to deadlines.
• Great attention to detail and accuracy.
• Ability 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.

Benefits

• Emotional well-being and physical health are important, which is why our employees receive a generous benefits package and a work culture that supports our core value of, “Treat others as you would like to be treated.”
• Competitive pay.
• 401(k) with up to 3.5% company match (1)
• Family, Health & Insurance Benefits (1), (2)
• Multiple health plan options including copay (FSA-eligible) and HSA eligible plans
• Wellness Incentive Program
• Dental and Vision plans
• Company-paid basic life, AD&D and long-term disability coverage
• Optional employee, spouse, and child life/AD&D insurance
• Optional accident, critical illness, and short-term disability coverage
• Dependent Care Flexible Spending Accounts
• Employee Assistance Program (EAP)
• Time Off paid holidays and sick days
• Generous vacation benefits based on years of service
• Eligibility begins the first of the month following 30 days of employment
• Full-time employees only, excluding EAP which is available to all Guardian employees

The Guardian Difference

Our clients require pharmacy services that aren’t “cookie cutter.” That’s why every Guardian pharmacy is locally operated and empowered with the autonomy to tailor their business to meet their clients’ needs. Our corporate support offices, based in Atlanta, Ga., provide services such as human resources, business intelligence, legal, and marketing to promote the success of each Guardian location. Regardless of your role at Guardian, your voice and talents matter. Because healthcare is an ever-changing industry, we encourage innovative thinking, intellectual curiosity, and diverse viewpoints to ensure we stay competitive in today’s dynamic business environment. At Guardian, we are dedicated to fostering and advancing a diverse and inclusive workforce. Join us to discover what your best work truly looks like.