Pharmacy Billing Tech Specialist Position Available In Davidson, Tennessee

Pharmacy Billing Tech Specialist
locations
TNO

• Park Pharmacy | Nashville, TN
  time type
  Full time
  posted on
  Posted 3 Days Ago
  job requisition id

R-0000013092

Tennessee Oncology, one of the nation’s largest, community-based cancer care specialists, is home to one of the leading clinical trial networks in the country. Established 1976 in Nashville, Tennessee Oncology’s mission remains unchanged: To provide access to high-quality cancer care and the expertise of clinical research for all patients, at convenient locations within their community and close to their home. Our growing network of physicians and locations is based on this mission. Tennessee Oncology is committed to advancing both the science of detection and targeted treatments, and to making these advances available to every patient. We believe caring for cancer patients is a privilege.
Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

Job Description:

The Park Pharmacy Billing Technician Specialist works under the direct supervision of the pharmacy managers at Park Pharmacy. The specialist is responsible for the daily preparation, posting, and balancing of receipts, running of daily reports, and patient/insurance AR reconciliation for Park Pharmacy.

ESSENTIAL FUNCTIONS

Perform insurance verification, order entry and prescription processing in pharmacy software for all payer sources
Document and report findings of reviewed pharmacy claims to supervisor
Serve as knowledge base expert on pharmacy claims processing and financial reviewer of claims
Receive and answer inquiries from Park Pharmacy teams about pharmacy claims and payers
Actively review current and past adjudicated pharmacy benefit claims for appropriateness and accuracy
Review and analyze trends of pharmacy claims for changes in key performance metrics (KPI) set by supervisor
Report significant changes in trends or KPIs to supervisor in a timely manner
Run assigned daily, weekly, and monthly reports, including weekly negative margin reports and hardship/foundation billing reports in pharmacy software.
Review weekly negative margin and hardship/foundation billing reports and correct all claims needing modification
Submit claim appeals on payer portals
Obtain and add copay cards, vouchers, and foundation assistance billing information to patient profile and rebill claims if necessary
Process patient refunds for claims needing billing modification
Assist A/R Specialists and Financial Counselors with responsibilities as needed
Advise Manager of any issues as they are identified
Perform additional duties as assigned by supervisor

KNOWLEDGE, SKILLS & ABILITIES

Ability to manage time and work with autonomy to meet deadlines
Ability to multitask while maintaining accuracy and proficiency
Ability to work within multiple computer platforms
Ability to work independently and cooperatively in a team environment.
Ability to critically analyze situations and identify possible solutions independently
Ability to be an active listener and possesses effective and professional communication skills
Knowledge of pharmacy claim adjudication process
Proficiency in Microsoft products including Excel, Word, PowerPoint and Access
Possess skills in data entry and basic computer usage

EDUCATION & EXPERIENCE

High School Diploma or equivalent

• required
  Minimum 5 years in retail pharmacy experience or 3 years in specialty pharmacy environment
• required
  Tennessee Board of Pharmacy license
• active and in good standing or obtained within 90 days of hire if not previously licensed in Tennessee
• required
  Pharmacy Technician Certification by an accredited body
• active and in good standing
  Alpha Numeric data entry experience with speed and accuracy
• required

PHYSICAL REQUIREMENTS

Some stress related to ensuring accuracy of work.

PHYSICAL REQUIREMENTS

Job Title:

Pharmacy Billing Technician Specialist
Physical Activity Required
Amount of time
None
Less than 1/3
(Occasionally)
1/3 to 2/3
(Frequently)
More than 2/3
(Regularly)
Standing
X
Walking
X
Sitting
X
Fingering or manual dexterity
X
Repetitive finger motion
X
Lifting or exerting force
X
Up to 10 pounds
X Up to 25 pounds
X
Up to 50 pounds
X
Up to 100 pounds
X
Over 100 pounds
X
Reaching or stretching
X
Climbing or balancing
X
Crouching or stooping
X
Speaking
X Hearing
X
Seeing (with correction)
X