Specialty Billing Coordinator

4 days ago


Louisville, Kentucky, United States Walgreens Full time

Job Summary:

The Specialty Billing Technician will be responsible for the accurate billing and collection of third party and patient payments for products and services rendered. This role requires strong communication and organizational skills, as well as the ability to work in a fast-paced environment.

Key Responsibilities:

  • Submit timely and accurate invoices to payers for products and services provided.
  • 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.
  • Process reimbursement checks/payment in accordance with policy.
  • Review price modify logs and ensure there are corresponding SDL 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 claims in accordance with company policy.

Additional Responsibilities:

  • Process prescription exceptions, including prior authorizations and referrals.
  • Proactively identify copay assistance opportunities.
  • Communicate with patients and providers regarding referral/prescription status.
  • Maintain a deep understanding of and assist patients with assistance programs enrollment.
  • Handle telephone calls that do not require personal attention of the pharmacist.
  • Maintain subject matter expertise pertaining to external billing practices.

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.
  • Experience providing customer service to internal and external customers.

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.
  • Experience entering data into databases.

Equal Opportunity Employer:

Walgreens is an Equal Opportunity Employer, including disability/veterans.

Actual Compensation:

The actual compensation that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors.


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