Pharmacy Technician - Billing Specialist

About the role

Boomer Solutions of Oklahoma City, a member of the Guardian family of pharmacies, is seeking a Pharmacy Billing Specialist to join our dynamic team in Oklahoma City, Oklahoma.

Responsibilities

• Process customer bills and insurance claims accurately and promptly.
• Assist with daily and monthly billing functions, including reporting.
• Provide excellent customer service to patients, caregivers, medical providers, and insurance carriers.
• Research and establish patient eligibility and coverage with insurance providers.
• Reverify benefit coverage criteria as needed for claims follow-up.
• Maintain and audit patient files and documentation to ensure compliance with payers and company standards.
• 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 and special enrollment periods.
• Evaluate and recommend cost-saving options for residents.
• Manage daily census, admit, discharge, and room changes for assigned facilities.
• Process patient payments, returns, and credits.
• Transmit individual credit card payments as needed.
• Pursue payment from delinquent accounts and arrange payment arrangements.
• Organize and provide requested audit documentation in a timely manner.
• Perform prescription claims adjudication, communicate with insurance companies, and make necessary corrections and rebills.
• Develop knowledge and proficiency in pharmacy facility billing requirements and utilize pharmacy information systems.
• Rotate through other departments to gain working knowledge of departmental workflows.
• Adhere to applicable government regulations, including HIPAA.
• Work collaboratively with team members to meet service goals.

Requirements

• 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 meet deadlines.
• Great attention to detail and accuracy.
• Ability to work in a fast-paced, team-oriented environment.

Qualifications

• Strong work ethic and integrity.
• Excellent relational skills to build relationships with business unit management.
• Strategic and planning abilities to think ahead and manage time efficiently.
• Problem-solving skills to analyze causes and solve problems at a functional level.
• Team-oriented skills to work effectively and collaboratively with all team members.

Benefits

Guardian offers a comprehensive Total Rewards package, including competitive pay, a 401(k) with company match, family, health, and insurance benefits, and more. Learn more about what we offer.

Pay

Compensation is competitive and commensurate with experience.

Schedule

Remote after training. Must live in the Oklahoma City area.