Adjudication Pharmacy Technician

Young at Heart Pharmacy•Indianapolis, IN

48d•Onsite

About The Position

Young at Heart Pharmacy is seeking a motivated and customer-oriented individual to join our team as an Adjudication Pharmacy Technician. As a vital part of our adjudication team, you will be responsible for ensuring prescriptions are dispensed to eligible patients and billed properly in accordance with their benefit plan. Additionally, you will maintain a positive and pleasant demeanor with all customers and colleagues while accurately confirming eligibility and billing.

Requirements

Active pharmacy technician license from the Indiana State Board of Pharmacy preferred
Previous pharmacy experience extremely valuable and desired
At least 1 year of billing experience
Proficient in Microsoft word and Excel

Responsibilities

Perform Billing duties as needed
Understand the pharmacy front-end process and perform point of sale functions (adjudication)
Contact payors and/or other outside agencies to verify information and resolve common, non-clinical problems
Run weekly billing reports
Obtain accurate billing and resident information, and rebill and resolve unpaid claims through adjudication
Re-bill and reconcile all incorrectly billed, non-clinical third-party denials
Identify and resolve and process denied claims in a timely manner
Document all communication concerning denied claims and any resolution communicated to facility or physicians
Obtain Prior Authorizations and non-covered forms
Obtain Part B documentation
Assist with billing DME supplies on line (Medicaid)
Resolve Hospice denials and communicate to Hospice nurses any denied claims
Adhere to and demonstrate mastery of current operating procedures
Use DocuTrack skills to locate specific documents and fax documents to facilities and/or for audit purposes
Stay in line with End of Month processes and deadlines
Ensure customer requests are handled quickly and professionally
Communicate effectively with customers to resolve billing inquiries
Communicate effectively with third party payors to resolve denied claims
Complete and verify pricing requests for customers
Direct specific inquiries to the appropriate team / individual
Maintain a positive, pleasant demeanor with all customers
Utilize robust problem-solving and people skills, patience, and telephone etiquette
Document customer issues using CPAS form and communicate to management
Work with Billing/Collection Managers on special projects as needed
Other duties as assigned