Specialty Billing Technician

Walgreens•Peoria, AZ

About The Position

Responsible for accurately billing and collecting third-party and patient payments for products and services rendered. The role submits and processes claims and payments, verifies authorizations and supporting documentation, manages patient balances, and researches billing issues. It also supports prescription exceptions and referrals, communicates prescription status to patients and providers, and assists patients with financial assistance program enrollment. The technician maintains expertise in external billing practices and helps coach pharmacy technicians and other support staff.

Requirements

High school diploma or equivalent.
Pharmacy Technician license in states where required.
Maintain PTCB or ExCPT certification through the designated training program and/or state-required certification or registration.
Experience communicating verbally and in writing with varied audiences.
Experience providing customer service to internal and external customers, meeting service quality standards, and evaluating customer satisfaction.
Experience with processes for submitting medical claims, including Medicare submission, EOBs, remittance advice, and timely filing limits.
Experience entering data into databases, such as MS Excel.

Nice To Haves

Six months of experience in a retail environment.
Prior work experience with Walgreens.

Responsibilities

Submit timely, accurate invoices to payers for products and services provided.
Determine the quantities and prices of products and services billed.
Verify that services and products are authorized and that required documentation is on file.
Ensure Medicare documentation is received from the medical provider and submitted to Danville.
Review reports to identify generic substitution opportunities.
Manage and collect patient balances before prescription dispensing or in accordance with company policy.
Ensure billing documentation is complete and accurate before claim submission.
Process reimbursement checks and payments according to policy.
Review price modification logs and ensure corresponding SDL (submit direct link) claims are present.
Research and resolve third-party chargebacks in a timely manner.
Assist with third-party audits according to company policy.
Process and file SDL claims according to company policy.
Process prescription exceptions, including prior authorizations, referrals to other Walgreens locations, and identifying copay assistance opportunities.
Communicate proactively with patients and providers about referral and prescription status.
Assist patients with financial assistance program enrollment, confirm eligibility, and maintain required reporting and documentation.
Handle telephone calls that do not require a pharmacist's personal attention, including calls to physicians and third-party payers.
Maintain expertise in external billing practices, including third-party adjudications, prior authorizations, and patient financial assistance programs, and coach pharmacy technicians and other support staff.