Specialty Billing Technician

Walgreens•Peoria, IL

8d•$20 - $26

About The Position

Responsible for the accurate billing and collection of third-party and patient payments for products and services rendered. The role handles billing documentation, claims, reimbursement payments, patient balances, prescription exceptions, and communication with patients, providers, and payers. It also 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 by phone, one-on-one, and to groups, and in writing through emails, letters, reports, and presentations to various audiences.
Experience providing customer service to internal and external customers, including meeting service quality standards and evaluating customer satisfaction.

Nice To Haves

Six months of experience in a retail environment preferred.
Prior work experience with Walgreens preferred.
Experience with medical claims submission processes, including Medicare submission, EOB (explanation of benefits), remittance advice, and timely filing limits.
Experience entering data into databases such as MS Excel.

Responsibilities

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