Licensed Pharmacy Technician
About The Position
Princing’s LTC Pharmacy is seeking a detail-oriented Claims Technician to join our growing team. This role is essential in ensuring accurate and timely billing so that our long-term care patients receive the medications they need without unnecessary delays. The Claims Technician is responsible for processing prescription claims, managing billing queues and batches, resolving rejected claims, and assisting with prior authorization needs. This position works closely with pharmacy staff, healthcare providers, and insurance companies to resolve billing issues and maintain accurate and timely claims processing.
Requirements
- High school diploma or equivalent
- Active State of Michigan Pharmacy Technician license
- Working knowledge of Medicaid, Medicare Part D, and private insurance
- Strong problem-solving skills, particularly with claim rejections and prior authorization issues
- Excellent attention to detail and accuracy
- Strong communication and time management skills
- Ability to multitask and prioritize in a fast-paced environment
- Ability to maintain strict patient confidentiality
Nice To Haves
- 1–2 years of pharmacy billing or healthcare claims processing experience preferred
- Experience with pharmacy billing platforms such as FrameworkLTC or QS/1 preferred
Responsibilities
- Process and submit daily prescription claims in real time
- Monitor and clear billing queues to maintain an efficient workflow
- Manage recurring billing cycles for long-term care and institutional patients
- Process accurate bulk claims related to cycle fill schedules
- Create, monitor, and manage billing batches within pharmacy systems
- Review batch exceptions and resolve billing issues
- Identify rejected claims and assist with the prior authorization process
- Work with providers and insurance payers to obtain prior authorization documentation and reprocess claims
- Update billing records when patients are admitted, discharged, or experience insurance or level-of-care changes
- Prioritize first-dose and urgent claims to support timely patient care
- Communicate and collaborate with the pharmacy team regarding time-sensitive billing issues
- Perform additional duties as assigned
Benefits
- Medical, Vision, & Dental Insurance
- 401(k) and Matching
- Employer-Funded Life Insurance
- Financial Counseling EAP
- Mental Health EAP
- Employer-Paid CE Credits
- PTO and Sick Time
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
