Specialty Billing Technician

Walgreens•Durham, NC

6d•$18 - $24

About The Position

Responsible for accurately billing and collecting third-party and patient payments for products and services rendered. The role includes submitting invoices and claims, verifying authorizations and documentation, managing patient balances and reimbursement payments, and resolving billing issues. It also supports prescription exceptions and patient assistance programs, communicates with patients and providers about prescription status, handles calls that do not require a pharmacist, and provides billing subject-matter guidance to 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 various audiences, including work groups, teams, company management, prospective acquisitions, and external clients.
Experience providing customer service to internal and external customers, 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 submitting medical claims, including Medicare submissions, and knowledge of EOBs (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.
Determine the correct quantities and prices for billed products and services.
Verify that services and products are properly authorized and required documentation is on file.
Ensure required 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 according to company policy.
Ensure all required billing documentation is complete and accurate before claim submission.
Process reimbursement checks and payments according to policy.
Review price modify logs and confirm that corresponding SDL (submit direct link) claims exist.
Review, research, and resolve third-party chargebacks in a timely manner.
Assist with third-party audits according to company policy.
Process and file SDL (submit direct link) claims according to company policy.
Process prescription exceptions, including prior authorizations, referrals to other Walgreens locations, and identification of copay assistance opportunities.
Proactively communicate with patients and providers about referral and prescription status.
Assist patients with enrollment in assistance programs, 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 expertise in external billing practices, including third-party adjudications, prior authorization, and patient financial assistance programs, and coach pharmacy technicians and other support staff.