Pharmacy Technician (Claims/Billing)
About The Position
Horizon LTC Pharmacy is seeking a full-time Claims Technician to join their long-term care pharmacy team in Grand Rapids, MI. The role involves processing and submitting daily prescription claims, managing billing queues, handling recurring and bulk billing cycles, and resolving billing issues. The company emphasizes accuracy, attention to detail, and providing fast, reliable, and compassionate service to residents, facilities, and care teams. Their mission is to optimize quality of life through personalized pharmacy solutions, guided by core values of teamwork, professionalism, positivity, continuous improvement, and customer focus.
Requirements
- High School Diploma or equivalent
- Michigan Pharmacy Technician License (required)
- 1-2 years of pharmacy billing or healthcare claims processing experience
- Experience with 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 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 the 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
