- Receive inbound and make outbound calls to healthcare professionals, patients and payers.
- Provide assistance with reimbursement inquiry requests, including insurance benefit verification, prior authorization, denials and appeals, and other reimbursement issues.
- May provide billing and coding information related to specific product(s).
- Conduct general payer research.
- Work with payers and healthcare professionals to resolve prior authorization issues and/or appeals and denials.
- Identify complex cases and triage appropriately to next level.
- Two year Pharmacy Technician degree or completion of a Pharmacy Technician Training Program or related four year degree (Science, Microbiology, Law, Chemistry) or commensurate experience in Pharmacy.
- Minimum of two years relevant experience (healthcare billing, physician office, health insurance processing) involving case management and/or patient interaction, preference with prior compounding pharmacy experience.Knowledge of medical insurance terminology.
- Previous experience with Pharmacy Benefits Management or Insurance Billing is highly desired.
- Computer skills with proficiency in Microsoft Office.
- One year data entry experience.
- Ability to multitask and prioritize in a fast-paced environment.
- Professional phone manner.
- Strong verbal communication and telephone skills.
- Problem solving, research, analytical, and troubleshooting skills.
- Excellent interpersonal skills.
- Customer service experience, strongly preferred.
Keywords: Pharmacy Technician, PharmD, Pharm D, Third Party Billing, Coordinator, Insurance, Reconciliation, 3rd Party Billing, Manager, Supervisor, Staff Clinical Pharmacist, Pharmacy, Retail Pharmacy, Hospital Pharmacist, Clinical Pharmacist, Pharmacist in Charge, Pharmacy, Pharmacy Manager, Director of Pharmacy, Clinical Coordinator, Assistant Director of Pharmacy, DOP, PIC, ADOP, Pharm D, Compunding, Sterile, Non-Sterile, Director of Pharmacy, Pharmacist, Clinical Pharmacist, Day Shift, Weekends, Hospital, Retail, Long Term Care, IV, Pediatrics, TPN, Pharmacokinetic, Dosing, Nuclear, Overnights, Second Shift, Traveling, Retail Staff Pharmacist, Staff Pharmacist, LTC, Dispensing, Pharmacy Billing Manager, Medical Billing, Medical Coding, Coding Specialist, Billing Coordinator, Insurance Billing, Compounding Billing Technician, Compounding Pharmacy, CphT, 3rd party billing manager.