Billing Pharmacy Technician – LTC

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Ensure accurate entry of profiles, processing, and follow-up concerning billing for resident prescriptions.

• Engage with community personnel, residents, and/or Power of Attorneys (POAs).

• Research, investigate, and remain updated on various insurance providers.

• Act as an advocate for residents while aiding the company's revenue-generating billing operations.

• Adjudicate insurance claims and resolve issues with rejected claims.

• Complete and monitor prior authorization forms.

• Input data into the Framework LTC and Framework ECM systems.

• Deliver timely and professional customer service via phone, email, and pharmacy messages.

• Produce monthly statements, manage and enter payments, and reconcile third-party claims.

• Review pre- and post-adjudication reports for training possibilities and compliance.

• Adhere to core processes and consistently complete responsibilities reliably on a regular basis.

⛳️ Requirements

• Knowledge of Medicare Part D, Medicaid, and Commercial insurances.

• Experience in adjudicating insurance claims and resolving rejected claims.

• Proficient in completing and/or following up on prior authorization forms.

• Data entry experience into Framework LTC and Framework ECM systems.

• Customer service experience through phone calls, emails, and pharmacy messages.

• Familiarity with generating monthly statements, processing and entering payments, and reconciling third-party claims.

• Ability to analyze pre- and post-adjudication reports for training opportunities and compliance.

• Capacity to adhere to core processes.

• Consistent performance of required duties on a regular basis.

• At least one year of pharmacy billing experience.

• A minimum of 2 years as a pharmacy technician.

• High School Diploma or equivalent.

• Licensed and in good standing as an Illinois Pharmacy Technician.

• National Pharmacy Technician Certification (PTCB or NHA).

• Basic knowledge of algebra and pharmaceutical mathematics.

• Timely and precise data entry skills.

• Excellent verbal and written communication abilities.

• Professional demeanor and appearance, along with superb customer service skills.

• Highly organized and detail-oriented.

• Capable of multitasking and working under tight deadlines.

• Motivated, punctual, and a dependable team member.

🏝️ Benefits

• Completely remote work setup.

• Full-time employment opportunity.

• Rotating Saturday work schedule.

• Chance to deliver outstanding customer service and advocate for residents.