Pharmacy billing includes processing prior authorizations, error resolutions, delinquent accounts and providing customer service to LTC and ALF facilities. May require maintaining computerized records, entry of patient specific information and preparing prescriptions under the direction of a pharmacist.
Direct supervisor is the Billing Supervisor. Works under the direction of licensed pharmacists.
Full or part time as needed. Assures smooth and efficient operations processing nursing facility’s resident prescriptions. Ability to handle computer tasks of some complexity and variety in an independent and responsible manner. Ability to work accurately and efficiently with attention to detail while following established protocol. Ability to utilize computer and learn required software as designated by company protocol. Must have communication skills to interact with SNF, ALF staff and Third Party Vendors.
Training and Experience::
* Minimal 18 years of age.
* Basic knowledge of billing and preferred PTCB certification.
* TN registration
* Detail oriented and ability to maintain accuracy.
* Ability to maintain confidentiality related to facility and residents medical information.
* Ability to communicate pharmaceutical information and demonstrate professional behavior while adhering to HIPPA regulations regarding confidentiality.
* Perform data entry duties with an eye for detail and accuracy.
* Maintain accurate records; communicate through reports or verbal dialogue to supervisor areas of concern.
* Utilize office technology including computer, software program, copier, etc.
* Display professional and appropriate appearance and behavior at all times
* Indoor with adequate lighting and ventilation, carpet, tile, wooden floors.
Relationship to other jobs::
This position entails working in an office setting while a variety of activities occur in immediate surroundings. Required to display professional manner and offer support to facility staff.
* Full or part time as designated by supervisor. Primary shift is days but may be required to work other shifts if discussed by supervisor. Shifts may vary and will be designated by supervisor.
* Category III. No exposure to bloodborne pathogens
* When working at computers utilize ergonomic keyboard, gel pads, mouse pad with wrist support. Review guidelines for setting up ergonomic work station and discuss with supervisor.
* Knowledge of insurance and the ability to work with insurance and the facilities to obtain Prior Authorizations.
* Knowledge of Accounts Receivable reports, Delinquent Account report, Error Resolution, and Audits
* Contact nursing facilities to note any concerns and to offer customer support.
* Keep Docutrak up to date and notify supervisor if concerns should arise
* Knowledge of procedures required to provide these services to nursing facilities.
* Knowledge of principles and processes for providing customer and person services including needs assessment techniques, quality service standards, and customer satisfaction evaluation techniques.
* Knowledge of laws, government regulations and agency rules which apply.
* Understanding written work related documents. Using mathematics to problem solve.
* Communicating with others in a supportive and functional capacity.
* The ability to read and understand information and ideas presented.
* May be required to assist pharmacist to prepare and label medications.
* May be required to prepare prescribed medication and/or prepare labels under the direction of the pharmacist.
* May be required to help in processing medication returns
* Knowledge of office procedures, computer skills, fax, copier etc.
* Building positive relationships with nursing facility staff