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Specialty Billing Coordinator
1 month ago
Job Summary
We are seeking a highly skilled Specialty Billing Coordinator to join our team at Walgreens. As a key member of our billing team, you will be responsible for ensuring accurate and timely billing and collection of third-party and patient payments for products and services rendered.
Key Responsibilities
- Submit accurate and timely invoices to payers for products and services provided.
- Determine quantities and prices for products and services billed, ensuring accuracy and compliance with company policies.
- Verify services and products are correctly authorized and required documentation is on file, ensuring seamless billing processes.
- Manage and collect patient balances prior to prescription dispensing, or in accordance with company policy.
- Review reports to maximize generic substitution opportunities and ensure optimal billing practices.
- Process reimbursement checks/payment in accordance with policy, ensuring timely and accurate payment processing.
- Review, research, and resolve all third-party chargebacks in a timely manner, maintaining excellent customer service.
- Assist with third-party audits, ensuring compliance with company policies and procedures.
- Process and file all SDL (submit direct link) claims in accordance with company policy, ensuring accurate and timely submission.
- Proactively identify copay assistance opportunities and communicate with patients and providers regarding referral/prescription status.
- Maintain a deep understanding of and assist patients with assistance programs enrollment, such as Chronic Disease Fund, confirming patient eligibility and all required reporting and documentation.
- Handle telephone calls that do not require personal attention of the pharmacist, including those to physicians and third-party payers.
- Maintain subject matter expertise pertaining to all external billing practices, including but not limited to third-party adjudications, prior authorization, and patient financial assistance programs, to coach pharmacy technicians and other support staff.
Requirements
- 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 communicating verbally and in writing to various audiences, including work groups, teams, company management, prospective acquisitions, and external clients.
- Experience providing customer service to internal and external customers, including meeting quality standards for services and evaluating 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, such as MS Excel.
