- Seattle, WA
What you'll be doing
- Function as primary third party billing resource for outpatient pharmacy staff. Contact department of health and caseworkers and patients with regard to missing documents for insurance plans. Work with financial counselors, HRSA, social workers, financial advocates and patients to monitor and review patients in spend down or pending DSHS status. Review pending reports from pharmacy management system and rebill claims when coverage is granted. Troubleshoot and resolve billing rejections and subsequently rebill claims to appropriate carrier for all commercial, federal and state insurance plans. Submit prior authorization requests, follow up on submitted prior authorization requests and submit claims with approvals as appropriate. Contact payers for lost medication overrides, replacement and vacation override approvals. Identify patients who may qualify for patient medication assistance programs or copay assistance. Review and screen new patients at intake to determine if patient has adequate prescription coverage. Refer appropriate patients to financial counseling for coverage or charity application. Assist with prescription audits. Establish and maintain good working relationships with billing operations specialists and outpatient clinic pharmacy staff to maintain effective communication regarding third-party billing issues. Educate pharmacy staff about third party billing policies and procedures as needed. Assist in the development, implementation and evaluation of third party billing policies and procedures. Assure that policies and procedures are followed in coordination with the billing operations specialists, leads, manager and director. Generate reports at the request of the manager or director. Assure compliance with all pharmacy laws and regulations. Know and follow all pharmacy department policies. Perform the duties of a pharmacy technician. Perform related duties as assigned.
What your background should be
- Licensure as a pharmacy technician with the Washington state board of pharmacy. A minimum of two years of experience as a pharmacy technician. Excellent communication and organization skills.
Required Schooling / Training
- High school degree or GED.
Who is the client company
- Concern about hospital & health care services.
- If you are interested in this position, send your resume to email@example.com