LTC Billing Technician

GRX Holdings, LLC is a fast growing, family-oriented group of independent pharmacies looking for a Full Time Billing Technician to work at our Medicap Long Term Care Pharmacy in Waterloo. This is not a remote position.

The Long-Term Care Billing Pharmacy Technician submits invoices for prescription claims to insurance companies and invoices private pay amounts to patients for a variety of billing cycles. This position must meet tight deadlines and be able to complete a variety of administrative tasks including posting payments to billing accounts.

Highly competitive pay rate commensurate with experience. Benefits and 401k with a company match, employee discount, and other benefits available. Fulltime positions are offered Medical/Dental/Vision benefits.

The following duties are normal for this position. These are not to be construed as exclusive or all inclusive. Other duties may be required and assigned.

• Prepare and submit claims to various insurance companies for prescription sales using FrameworksLTC software.
• Answer questions from long-term care facilities (“LTC”), patients, pharmacy personnel and insurance companies.
• Manage the set-up and maintenance of resident’s files in accordance with company standards.
• Investigate and resolve patient billing questions.
• Resolve patient complaints appropriately.
• Prepare, review and distribute patient statements to LTC Facilities within required deadlines
• Maintain a working relationship with assigned LTC Facilities and Group Homes to ensure resident’s billing status is correct.
• Obtain, track and follow-up on prior approvals for all medications or items as required by payers
• Process returns and credits of medications
• Organize documents for insurance audits
• Review resident face sheets and make corrections if needed
• Contact insurance companies for benefit investigation and coverage eligibility
• Assist with billing of items used from emergency kits
• Monitor, maintain and ensure adequate office supply inventory
• Perform various collection functions including contacting patients by phone, correcting and resubmitting claims to third party payers.
• Process payments from insurance companies, posting to patient and third-party accounts.
• Continually look for process improvements to increase efficiencies in work performed.
• Adhere to all HIPAA guidelines/regulations.
• Perform additional duties as assigned by Supervisor.
• Knowledge of FrameworkLTC software preferred but not required.
• Pharmacy Technician experience preferred.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the minimum knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of medical billing/collection practices.
• Knowledge of Medicare, Medicaid and third party billing requirements
• Ability to operate a computer and basic office equipment.
• Knowledge of business office procedures.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Skill in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, employees and the public.
• Highly organized and detail oriented
• Proficient in Microsoft Office products (Word, Excel)
• Ability to meet deadlines
• Ability to manage competing priorities in a professional manner
• Ability to think “on your feet”

EDUCATION and/or EXPERIENCE

• High School Diploma
• 2 years of billing experience required.
• Minimum 2 years’ experience working in professional office environment.
• Knowledge of FrameworkLTC software preferred but not required.
• Pharmacy Technician experience preferred.

Experience:

• pharmacy: 1 year (Preferred)
• Long term care pharmacy: 1 year (Preferred)
• billing: 1 year (Required)