Specialty Billing Technician

1 month ago

New Brunswick, United States WALGREENS Full time

Responsible for the accurate billing and collection of third party and patient payments for products and services rendered.

**Job Responsibilities (listed in order of importance and/or time spent)**
- Submit timely, accurate invoices to payer for products and services provided.
- Correctly determine quantities and prices for products and services billed.
- Verify services and products are correctly authorized and required documentation is on file.
- Ensure all Medicare documentation is received from the medical provider and submitted to Danville.
- Review reports to maximize generic substitution opportunities.
- Manage and collect patient balances prior to prescription dispensing, or in accordance with company policy.
- Ensure all required documentation for billing is completed and accurate prior to claim submission (i.e., medical claims billing).
- Process reimbursement checks/payment in accordance with policy.
- Review price modify logs and ensure there are corresponding SDL (submit direct link) claims.
- Review, research and resolve all third party chargebacks in a timely manner.
- Assist with any third party audits, in accordance with company policy.
- Process and file all SDL (submit direct link) claims in accordance with company policy.
- Processing of prescription exceptions including prior authorizations, triaging of referrals to other Walgreens locations, and proactively identifying copay assistance opportunities.
- Responsible for proactive communication to patients and providers regarding referral/prescription status.
- Responsible for maintaining a deep understanding of and assisting patients with assistance programs enrollment, such as Chronic Disease Fund, confirming patient eligibility and all required reporting and documentation.
- Handles telephone calls that do not require personal attention of the pharmacist, including those to physicians and third party payers.

**Basic Qualifications**
- High School Diploma or equivalent.
- Pharmacy Technician license, in states where required.
- Maintains PTCB or ExCPT certification through the designated PTCB or ExCPT training program and/or state required certification/registration.
- Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.

**Preferred Qualifications**
- Prefer six months of experience in a retail environment.
- Prefer to have prior work experience with Walgreens.
- Experience in processes related to submitting medical claims, including but not limited to Medicare submission, knowledgeable in EOB (explanation of benefits), remittance advice and adherence to timely filing limits.
- Experience entering data into databases (e.g., MS Excel).

The following information is applicable for San Francisco, CA applicants: Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

An Equal Opportunity Employer, including disability/veterans.

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