Lexington, Kentucky

Specialty Billing Technician

Address: 393 WALLER AVE,STE 5,LEXINGTON,KY,40504-02914-21170-S
Job ID 1072414BR
Job Type: Part-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.
  • Maintains subject matter expertise pertaining to all external billing practices including but not limited to third party adjudications, prior authorization, and patient financial assistance programs in order to coach pharmacy technicians and other support staff.

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 communicating both verbally (on phone, one-on-one, to groups) and in writing (emails, letters, reports, presentations) to various audiences (work group, team, company management, prospective acquisitions, external clients).
  • 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.

To see the salary range for this position please click here: . If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser https://jobs.walgreens.com/en/paysbt

Lexington, Kentucky

Walgreens (walgreens.com), one of the nation's largest drugstore chains, is included in the Retail Pharmacy USA Division of Walgreens Boots Alliance, Inc. (Nasdaq: WBA), a global leader in retail and wholesale pharmacy. Walgreens is proud to be a neighborhood health, beauty and retail destination supporting communities across the country, and was named to FORTUNE* magazine’s 2019 Companies that Change the World list.

Approximately 8 million customers interact with Walgreens in stores and online each day. As of August 31, 2019, Walgreens operates 9,277 drugstores with a presence in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands, along with its omnichannel business, Walgreens.com. Walgreens also provides specialty pharmacy and mail services and offers in-store clinics and other health care services throughout the United States, most of which are operated by our health care strategic partners.

Walgreens is the the Retail Pharmacy USA Division of Walgreens Boots Alliance, Inc. (WBA), and WBA is currently ranked No. 1 in the Food and Drug Industry list of Fortune's World Most Admired Companies (2019), and has been included on this list as WBA (or previously as Walgreen Co.) for the past 26 consecutive years.

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