Flexible Pharmacy Staffing has an opening for Medicare D Billing Pharmacy Technicians at a long term care pharmacy in Arlington, Texas.
Monday - Friday
4:00 pm to 12:30 am
Serves as a key point of contact for the Clinical Hub and proactively communicates with Pharmacists, Facilities, Physicians and PDP’s regarding Therapeutic Interchanges, and prior authorization requests. They are responsible for investigating and calling the plans to determine the reasons for payment denials, the Physicians, and Facilities to provide the reasons for denial, while updating and documenting prior authorizations with clinical justifications, under the supervision of a registered Pharmacist.
- Act as a resource to the facilities in obtaining information completing necessary documentation or following up on outstanding claims.
- Certified Pharmacy Technician with an understanding of Insurance and Medicaid formularies and processes including the prior authorization processes.
- Makes outgoing calls to Facilities, Plans, and Physician’s offices as needed to obtain approvals
- Works with Client Billing Service Offices, Pharmacy Directors, customers, and prescription drug plans to effectively communicate and resolve customer issues.
- Work closely with peers and management.
- Performs other tasks as assigned.
- Maintain a clean and organized work area.
- Achieves productivity goals with regard to calls/claims per hour as determined by the Director and Clinical Hub Manager.
- Provide clinical support to members of the team regarding prior authorization concerns
- Develop a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow.
- Prioritize work to meet daily and competing deadlines.
- Certified Pharmacy Technician
- Third-Party Medical Billing Experience
- Prior Call Center or Pharmacy Billing Experience
- Drug-Free and clean background checks
- Good and relevant supervisor-based references
- Reliable and punctual
- Be mature and responsible: Perfect Attendance is our goal!
- Knowledge of drugs, medical nomenclature, and the metric system
- Excellent communication skills; ability to read, write, and communicate effectively in English
- High level of accuracy and attention to detail, good organizational skills, self-motivated and able to work independently
- Bachelor's Degree
- 1-3 Years of Pharmacy Experience
- 3 Years Call Center Experience