Pharmacy Third-Party Specialist

TCC Health • Dunkirk, NY

3d • Hybrid

About The Position

The Pharmacy Third-Party specialist focuses on managing and resolving issues related to the third-party insurance claims and billing in a pharmacy setting. This position will be able to pick their main location between our Jamestown or Dunkirk location.

Requirements

• High School Diploma or equivalent General Education Development (GED) certificate
• Strong understanding of medical terminology and pharmacy-related concepts.
• Customer service skills to handle patient needs effectively and efficiently.
• Proficiency in Microsoft Office Suite.
• Ability to work independently or as part of a team.
• Capability to identify problems, analyze options and implement effective strategies to overcome obstacles.
• Ability to manage multiple tasks, prioritize workload and maintain accurate records.
• Capacity to handle fast paced environment to meet deadlines.
• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Communicating with others to exchange information.
• Repeating motions that may include the wrists, hands and/or fingers.
• Sedentary work that primarily involves sitting/standing.

Nice To Haves

• Certified Pharmacy Technician (CPhT) preferred

Responsibilities

• Ensuring accuracy and completeness of information for timely and accurate reimbursement.
• Investigating and addressing rejected claims, working with insurance companies to obtain necessary information, corrections and prior authorizations.
• Ensuring timely payment and resolving any discrepancies.
• Keeping detailed records of claims, billing and reimbursements while staying up to date on insurance company policies and procedures.
• Acting as a point of contact between the pharmacy staff, patients and insurance companies.
• Assisting pharmacy staff and patients with billing related questions or issues.
• Contributing to the development of effective billing practices.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED