Pharmacy Technician (Claims and Billing)
About The Position
Princing's LTC Pharmacy is seeking a full-time Claims Technician to join their long-term care pharmacy team in Saginaw, MI. The role involves ensuring the billing workflow runs smoothly by processing and submitting daily prescription claims, managing recurring billing cycles, handling bulk claims, and creating/monitoring billing batches. The technician will also be responsible for reviewing batch exceptions, resolving issues, identifying rejected claims, navigating the prior authorization process, and updating billing records for patient changes. Prioritizing first-dose and urgent claims, and collaborating with the pharmacy team on billing issues are also key aspects of the role. The company emphasizes supporting residents, facilities, and care teams with fast, reliable, and compassionate service, aiming to optimize quality of life through personalized pharmacy solutions.
Requirements
- High School Diploma or equivalent
- Michigan Pharmacy Technician License (required)
- 1-2 years of pharmacy billing or healthcare claims processing experience
- Experience with the pharmacy billing platforms like FrameworkLTC or QS/1
- Solid understanding of Medicaid, Medicare Part D, and private insurance
- Strong problem-solving ability when it comes to claim rejections and PA issues
- Excellent attention to detail, communication, and time management
- A commitment to patient confidentiality
Responsibilities
- Processing and submitting daily prescription claims in real time
- Monitoring and clearing billing queues to maintain workflow
- Managing recurring billing cycles for long-term care and institutional patients
- Handling timely, accurate bulk claims tied to cycle fill schedules
- Creating, monitoring, and managing billing batches within our pharmacy systems
- Reviewing batch exceptions and resolving issues quickly
- Identifying rejected claims and navigating the prior authorization process
- Working with providers and payers to gather prior authorization documentation and reprocess claims
- Updating billing records when patients are admitted, discharged, or have insurance or level-of-care changes
- Prioritizing first-dose and urgent claims to support immediate patient needs
- Communicating and collaborating with our pharmacy team on time-sensitive billing issues
- Supporting the team with additional tasks as needed
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
