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Referral and Billing Services - Pharmacy Technician

Location: Portland, OR (On‐site)

Schedule: Full-time, 40 hrs/week - paying hourly

Pay: $23-25/hr

License Required: Active Oregon Pharmacy Technician License
Key Responsibilities:

• Provides day-to-day leadership, guidance, and direct support to the Billing and Resource Teams to
• When directed, communicates items of potential operational impact to leadership as appropriate. Coordinates responses to escalated payer inquiries and communicates escalated patient needs to payers, with guidance from operational leadership.
• Responsible for application tasks, including but not limited to:
• Processing incoming documents
• Maintaining patient records
• Loading insurance information
• Performing prescription data entry
• Processing prior authorization notices
• Performing and reviewing claim submission and reversal
• Addressing billing exceptions
• Support accounts receivable processing needs
• Reports any identified obstacles or improvements to workflow to operational leadership.
• Troubleshoots adjudication issues and is well versed in the nuances of insurance billing and benefits investigation.
• Fields multi-department email requests and addresses issues or facilitates routing to alternate department.
• Supports creation and revision of team process documents.
• Supports call center when business needs arise.
• Interacts with all areas of Ardon Health to correct or enhance specific implementation activities as identified through customer service issues (billing, coordination of benefits, payment processing), observation, and communication with patients or group contacts.
• Assists manager with testing new processes, developing training and operational materials, and writing business requirement documents.
• Maintains active Oregon license. Informs supervisor within 1 business day (and Oregon Board of Pharmacy within 10 days) of any arrests, convictions, suspected or known violations of law, or any other conduct that might affect or has affected license status. Reports to Oregon Board of Pharmacy within 15 days any changes to name, residence address, or employment.
• Actively participates and provides support as needed to leadership and quality program staff to ensure activities related to the company’s quality management program and quality improvement activities maintain priority focus and are effectively executed. This may include but is not limited to activities that promote objective and systematic measurement, monitoring, and evaluation of services and defined Quality Improvement Projects (QIPs) that may result from such efforts.
• Complies with the company’s Human Resources policies, Employee Handbook, Code of Conduct, and all department policies and procedures, including protecting confidential company, employee, and customer information; attending work punctually and regularly; and adhering to good safety practices in all activities.
• Performs other duties and responsibilities as assigned.

Required skills:

• Education and experience
• Required:
• High school diploma or GED.
• Active Oregon Pharmacy Technician License. A Certified Oregon Pharmacy Technician License will be required prior to expiration of existing Oregon license or as required by the Oregon Board of Pharmacy.
• Preferred:
• Successfully meets all essential functions of Billing and Insurance level I and level II positions and/or Referral Resource Specialist level I and II positions and/or equivalent experience.
• Prior work experience in a customer service setting.
• Minimum 2 years’ work experience in a pharmacy setting.
• Work experience in a specialty pharmacy setting.
• Physical and mental functions and activities
• Must be able to be innovative, solution-oriented and to strive for best practices.
• Must be able to shift direction based on business needs while successfully remaining focused.
• Must demonstrate excellent customer service skills and the ability to express compassion and empathy.
• Must be able to multi-task and work in a fast-paced environment.
• Must demonstrate teamwork and a positive outlook.
• Must have excellent verbal, written, and interpersonal communication skills.
• Must be able to express oneself, detect, perceive, observe, and assess information exchanged in a variety of communication methods.
• Must be able to demonstrate proficiency with computer applications.
• Must be able to work independently as well as part of a team.
• Must be able to provide timely, accurate, courteous, and concise responses to escalated inquiries in person, by telephone, or by correspondence.
• Must have strong knowledge of prescription intake requirements, insurance plans, and patient assistance programs with the ability to assist patients to coordinate insurance benefits and/or explore options for copay and other financial assistance.
• Must be able to manage and support special projects as assigned.
• Must be able to manage escalated issues that occur within pharmacy software system work queues.
• Must be able to understand and interpret claims adjudication issues with Pharmacy Benefit Management organizations, insurance plans, and Patient Assistance Programs.
• Must be able to accurately utilize applicable computer software and equipment for pharmacy claims processing.
• Working conditions
• Work is performed primarily at a desk, with extensive keyboard and telephone work in a stationary position.
• Business needs may occasionally require work in excess of 40 hours per week, including work outside of standard work week.
• Contact with others:
• Internally with Ardon employees across multiple departments.
• Externally with patients, prescribers, prescriber agents, clients, third-party payers, HUBs, and manufacturers.

Our ideal candidate has:

• Strong communication and interpersonal skills.
• Ability to effectively collaborate in a team setting.
• Proficiency in standard workplace software and/or information management applications.
• Prior experience working in a pharmacy or healthcare setting.
• Ability to navigate computer applications.
• Ability to work in a fast-paced environment.
• Knowledge of pharmacy benefit investigation, prior authorization support, and patient financial assistance connection.
• Prior experience working with physicians, nurses, or other healthcare professionals.

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Free parking
• Health insurance
• Health savings account
• Opportunities for advancement
• Paid sick time
• Paid time off
• Parental leave
• Vision insurance