- 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.
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Headhunters, LLC - 9 months ago