Imeediate Needs:

Billing experience preferably in a Long Term care pharmacy Day shift - 8am to 4:30pm Must have Frameworks pharmacy platform experience. This is a Temp to permanent position Must be applying to the PA state board for pharmacy Tech license - CPhT Certified Responsibilities Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities. Reverify benefit coverage criteria as needed for claims follow up. Accurately enters and/or updates patient/insurance information into billing system. Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance. Accurately enter patient information into the pharmacy system. Provide assistance and timely response to all billing customer inquiries via phone or electronic communications. Research and resolve patient billing issues regarding insurance eligibility, coverage, and related benefits. Provide guidance and support to resident or responsible party by running Medicare plan comparisons during open enrollment and special enrollment periods. Proactively review patient profiles, drug regimens and insurance coverage to evaluate options to save resident money. Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed. Make corrections as needed and rebill claims as necessary. Develop knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances)

EDUCATION AND/OR CERTIFICATIONS

High School Diploma or GED required. Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required (pharmacy specific). Framework Experience required

Skills :

Billing experience Frameworks experience

Pay:

$24.00 - $29.00 per hour Application Question(s): Have you worked in a Long Term Care Pharmacy? Do you have Framework's experience? If offer the position, when can you start? Do you have Pharmacy Billing and or data entry experience? (Dealbreaker)

Work Location:

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