Billing Coordinator – Specialty Pharmacy

This is a fully remote position, open to applicants in Colorado, +1 more state.

📋 Description

• Oversee the adjudication inboxes

• Support the medical claims billing process

• Troubleshoot orders with rejected statuses, including refill too soon, dose modifications, duplicate claims, and eligibility concerns

• Reconcile the master claims queue effectively

• Assist with billing projects, such as the Member AR report and COGS

• Ensure the accuracy of insurance information for proper adjudication

• Aid patients in re-enrolling in copay cards and patient assistance programs

• Communicate with patient assistance programs as needed to secure payment

• Assist in the timely initiation and resolution of prior authorizations

• Collaborate with relevant staff to resolve claims-related issues

• Adhere to and support the enforcement of company policies and procedures

• Undertake other assigned duties

• Work in a standard office setting with extended periods of sitting and standing in front of a computer

• Utilize standard computer, phone, and office equipment

• May be required to work extended hours and manage occasional high-stress interactions with customers, clients, and employees

⛳️ Requirements

• High School Diploma or equivalent

• Certification and Registration as a Pharmacy Technician in Colorado, in good standing, is mandatory

• Registration with the State of Florida (for Florida technicians only) in good standing is required

• Certification is preferred for pharmacy technicians in Florida

• Previous experience in Prior Authorization or Claims is preferred

• Displays a high level of personal accountability regarding the accuracy and quality of work

• Exhibits the ability to work efficiently and meet expected productivity levels

• Ensures the accuracy of information provided to Management for review

• Organizes own schedule based on priorities

• Demonstrates exceptional customer service and professionalism

• Capable of multi-tasking

• Skilled in communicating effectively, patiently, and courteously

• Able to thrive in a fast-paced, stressful environment

• Should be self-sufficient and self-motivated

• Maintains a reliable attendance record

• Respects and upholds the confidentiality guidelines of HIPAA

🏝️ Benefits

• Competitive salary

• Health and wellness benefits

• Opportunities for professional development

• Supportive work environment

• Flexible working hours