Billing Specialist-Mail Order

Job Summary: Responsible for all aspects related to adjudication and billing of mail order prescriptions in a pharmacy setting.

Job Duties:

• Responsible for monitoring adjudication queue(s)
• Responsible for contacting members and prescribers on non-covered items
• Facilitate prior authorization process for customers through designated PA portals
• Provide professional communication to contracted clients
• Provide timely resolution to all internal communication inquires relating to rejections or overrides
• Customer service coverage for outbound calls and directing incoming calls
• Provides resolution to customer service issues to ensure member satisfaction
• Maintain and keep reasonable production as determined by supervisor
• May assist in orienting and training new employees
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Job Skill Requirements:

• Broad knowledge of medications, physician orders, and pharmacy systems
• Familiar with Enterprise billing options and practices surrounding claim submission
• Strong communication skills
• Outstanding customer service skills
• Excellent organization skills
• Ability to multitask and prioritize
• Excellent computer and keyboarding skills
• Successful completion of a pre-employment and/or random drug screening test

Educational Requirements:

• Minimum: High School Diploma or GED
• Preferred: Pharmacy technician or related certification

Experience:

• Experience in a customer service-related field
• 6-12 months experience as a pharmacy technician preferred