Pharmacy Billing Coordinator Technician III

Fred Hutchinson Cancer Center•Seattle, WA

2d•Hybrid

About The Position

The Pharmacy Billing Coordinator (PBC) ensures authorizations for drug therapy are completed in accordance with payer criteria and policy, in a timely manner and before therapy begins. The role supports the Fred Hutch retail specialty pharmacy team with claim rejections and communication with pharmacy benefit managers (PBMs) and the care team. It also performs Pharmacy Technician III operational functions required for the role. The PBC independently performs varied technical pharmacy billing functions to ensure prescriptions are billed accurately. The position works with stakeholders inside and outside the pharmacy department on complex tasks involving patient care, financial and billing practices, and regulatory compliance. The role is full time, Monday through Friday, 9:30 AM to 6:00 PM, with work performed partly on campus and partly remotely.

Requirements

High school diploma or equivalent.
Current Washington State pharmacy technician certification and Washington State Pharmacy Technician License.
Two years of pharmacy technician experience.
Proficiency in Microsoft Suite.
Ability to communicate verbally in person and by phone, and in writing, clearly, concisely, and professionally.
Ability to perform basic pharmaceutical calculations.
Ability to use a mouse, navigate computer programs, and enter data into computer systems accurately and efficiently.
Familiarity with generic drug names and their basic indications.
Ability to review and correct discrepancies identified in daily, weekly, and monthly billing reports.
Ability to work in a fast-paced and complex environment.

Nice To Haves

Bachelor’s degree.
Attention to detail and accuracy in documenting information.
Ability to multitask and work efficiently in a dynamic work environment.
Ability to work effectively as a member of a team.
Experience with electronic medical records.
Previous experience in pharmacy billing.
Knowledge of CPT, ICD-10, and other medical terminology.
Knowledge of the health care environment and electronic medical records.
Participation in professional pharmacy organizations.

Responsibilities

Perform complex and unique duties within the pharmacy department.
Interpret, evaluate, and summarize information and datasets of varying sizes.
Communicate effectively and professionally with stakeholders inside and outside the pharmacy department.
Develop and maintain relationships with internal and external stakeholders, including vendors, payors, and distributors.
Work independently and with teams to complete tasks.
Document information and results clearly and concisely.
Generate and present reports of tasks to the Pharmacy Operations Manager or Director of Pharmacy.
Determine benefit limits and secure insurance approvals for specialty and high-cost medications.
Work with the care team to communicate coverage issues.
Evaluate patterns in denied claims, take corrective action, and educate staff as needed.
Liaise with Patient Financial Services.
Serve as a resource to patients and staff regarding insurance and drug coverage questions.
Provide information and education about patient assistance programs to providers, patients, and medical center staff.
Complete and submit prior authorization forms and patient assistance applications.
Reprocess denied or rejected third-party claims.
Train and educate staff on pharmacy billing functions.
Participate in billing-related meetings.
Perform retail pharmacy reconciliation and reporting.
Perform other pharmacy-related duties in accordance with Washington State Pharmacy Quality Assurance Commission regulations.
Promote an image of service and goodwill to patients, the public, and hospital staff.
Perform other related tasks as required.