Demo

Pharmacy Claims Technician

Kalamazoo Long Term Care Pharmacy
Grand Rapids, MI Full Time
POSTED ON 11/15/2025
AVAILABLE BEFORE 1/14/2026
Salary: $18-$22Claims Technician -- Horizon LTC PharmacyFull-Time | Grand Rapids, MIAre you someone who loves accuracy, enjoys solving billing puzzles, and wants to work where your attention to detail truly makes a difference? Horizon LTC Pharmacy is looking for afull-time Claims Technicianto join our growing long-term care pharmacy team.At Horizon LTC, we pride ourselves on supporting residents, facilities, and care teams with fast, reliable, and compassionate service. As part of our team, you'll be surrounded by a supportive network and a company commmitted to high-quality, patient-centered care.Our mission is simple:optimize the quality of life through personalized pharmacy solutions. And we live by our core values:be a team player, be professional, be positive, get better, and put the customer first. If those resonate with you, keep reading!What You'll DoYou'll play a key role in keeping our billing workflow running smoothly every single day. Your responsibilities will include:Processing and submitting daily prescription claims in real timeMonitoring and clearing billing queues to maintain workflowManaging recurring billing cycles for long-term care and institutional patientsHandling timely, accurate bulk claims tied to cycle fill schedulesCreating, monitoring, and managing billing batches within our pharmacy systemsReviewing batch exceptions and resolving issues quicklyIdentifying rejected claims and navigating the prior autorization processWorking with providers and payers to gather prior authorization documentation and reprocess claimsUpdating billing records when patients are admitted, discharged, or have insurance or level-of-care changesPrioritizing first-dose and urgent claims to support immediate patient needsCommunicating and collaborating with our pharmacy team on time-sensitive billing issuesSupporting the team with additional tasks as neededWhat You'll BringWe're looking for someone who can combine technical know-how with a strong sense of responsibility:High School Diploma or equivalentMichigan Pharmacy Technician License (required)1-2 years of pharmacy billing or healthcare claims processing experienceExperience with the pharmacy billing platforms like FrameworkLTC or QS/1Solid understanding of Medicaid, Medicare Part D, and private insuranceStrong problem-solving ability when it comes to claim rejections and PA issuesExcellent attention to detail, communication, and time managementA commitment to patient confidentialityWhy You'll Love Working at Horizon LTCAt Horizon LTC Pharmacy, you're not just joining a pharmacy--you're joining a team that cares deeply about the patients and facilities we serve. Your work directly ensures that residents receive the medications they need--on time, every time. And that means your role truly matters. If you want to put your billing skills to work in a mission-driven pharmacy setting, this could be the perfect opportunity.If you're ready to grow your career with a supportive long-term care pharmacy team, we'd love to meet with you!

Salary : $18 - $22

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