Specialty Billing Technician

Job Responsibilities

• Submit timely, accurate invoices to payer for products and services provided.
• Correctly determine quantities and prices for products and services billed.
• Verify services and products are correctly authorized and required documentation is on file.
• Ensure all Medicare documentation is received from the medical provider and submitted to Danville.
• Review reports to maximize generic substitution opportunities.
• Manage and collect patient balances prior to prescription dispensing, or in accordance with company policy.
• Ensure all required documentation for billing is completed and accurate prior to claim submission (i.e., medical claims billing).
• Process reimbursement checks/payment in accordance with policy.
• Review price modify logs and ensure there are corresponding SDL (submit direct link) claims.
• Review, research and resolve all third party chargebacks in a timely manner.
• Assist with any third party audits, in accordance with company policy.
• Process and file all SDL (submit direct link) claims in accordance with company policy.
• Process prescription exceptions including prior authorizations, triaging of referrals to other Walgreens locations, and proactively identifying copay assistance opportunities.
• Communicate with patients and providers regarding referral/prescription status.
• Maintain subject matter expertise pertaining to all external billing practices including but not limited to third party adjudications, prior authorization, and patient financial assistance programs.
• Coach pharmacy technicians and other support staff.

Qualifications

• High School Diploma or equivalent.
• Pharmacy Technician license, in states where required.
• Maintains PTCB or ExCPT certification through the designated PTCB or ExCPT training program and/or state required certification/registration.
• Experience communicating both verbally (on phone, one-on-one, to groups) and in writing (emails, letters, reports, presentations) to various audiences (work group, team, company management, prospective acquisitions, external clients).
• Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.