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Claims Technician

Full-Time |$18 - $22 per hour

Princing's LTC Pharmacy | Saginaw, MI

Princing's LTC Pharmacy is seeking a detail-oriented Claims Technician to join our growing team. This role is essential in ensuring accurate and timely billing so that our long-term care patients receive the medications they need without unnecessary delays.

Position Summary

The Claims Technician is responsible for processing prescription claims, managing billing queues and batches, resolving rejected claims, and assisting with prior authorization needs. This position works closely with pharmacy staff, healthcare providers, and insurance companies to resolve billing issues and maintain accurate and timely claims processing.

Our Benefits

• Medical, Vision, & Dental Insurance
• 401(k) and Matching
• Employer-Funded Life Insurance
• Financial Counseling EAP
• Mental Health EAP
• Employer-Paid CE Credits
• PTO and Sick Time

Key Responsibilities

• Process and submit daily prescription claims in real time
• Monitor and clear billing queues to maintain an efficient workflow
• Manage recurring billing cycles for long-term care and institutional patients
• Process accurate bulk claims related to cycle fill schedules
• Create, monitor, and manage billing batches within pharmacy systems
• Review batch exceptions and resolve billing issues
• Identify rejected claims and assist with the prior authorization process
• Work with providers and insurance payers to obtain prior authorization documentation and reprocess claims
• Update billing records when patients are admitted, discharged, or experience insurance or level-of-care changes
• Prioritize first-dose and urgent claims to support timely patient care
• Communicate and collaborate with the pharmacy team regarding time-sensitive billing issues
• Perform additional duties as assigned

Qualifications

• High school diploma or equivalent
• Active State of Michigan Pharmacy Technician license
• 1-2 years of pharmacy billing or healthcare claims processing experience preferred
• Experience with pharmacy billing platforms such as FrameworkLTC or QS/1 preferred
• Working knowledge of Medicaid, Medicare Part D, and private insurance
• Strong problem-solving skills, particularly with claim rejections and prior authorization issues
• Excellent attention to detail and accuracy
• Strong communication and time management skills
• Ability to multitask and prioritize in a fast-paced environment
• Ability to maintain strict patient confidentiality

Skills & Competencies

• Exceptional attention to detail and accuracy
• Strong organizational and prioritization skills
• Ability to identify and resolve billing issues
• Strong problem-solving and analytical skills
• Professional communication with pharmacy staff, providers, and insurance representatives
• Ability to manage multiple tasks and meet deadlines

Work Environment

• 
  Office-based long-term care pharmacy setting
• Moderate noise level
• Frequent sitting and computer-based work
• Repetitive hand use
• Requires sustained attention to detail and accuracy

Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.

Why Join Princing's LTC Pharmacy?

At Princing's LTC Pharmacy, our mission is to optimize the quality of life for the patients and facilities we serve. We value professionalism, teamwork, and a commitment to continuous improvement.

If you are a licensed or certified pharmacy technician looking for a stable, full-time position in a collaborative long-term care environment, apply today!