Pharmacy Billing Representative

Pharmacy Billing Representative

HealthCare Support is actively seeking a Pharmacy Billing Representative to fill an opening in Arlington, Texas

Daily Responsibilities for Pharmacy Billing Representative:

• Act as a resource to the facilities in obtaining information completing necessary documentation or following up on outstanding claims.
   

• Individual with an understanding of Insurance and Medicaid formularies and processes including the prior authorization processes.

• Makes outgoing calls to Facilities, Plans, and Physician’s offices as needed to obtain approvals
  Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to effectively communicate and resolve customer issues.
   

• Performs other tasks as assigned.
   

• Achieves productivity goals with regard to calls/claims per hour as determined by the Director and Clinical Hub Manager.
   

• Provide clinical support to members of the RxAllow team regarding prior authorization concerns / submissions.
   

• Conducts job responsibilities in accordance with the standards set out in the Company’s code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and State Laws, and applicable professional standards.
   

• Familiar with the claim adjudication process.
   

• Develop a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow.
   

• Prioritize work to meet daily and competing deadlines.
   

• Proficiency in Microsoft Office programs.

Shift:  Shift: Monday – Friday 9:00am-5:30pm

Required Qualifications for Pharmacy Billing Representative:
Certified Pharmacy Technician, Data Enty skills, research ability, Insurance experience, 40 WPM, excel experience, Frameworks and LTC400 experience preferred. 
 

Education/Learning Experience:
 

• Required: High School Diploma, Associates Degree
   

• Desired: Certified Pharmacy Technician or Medical Assistant Certification
   

• Desired: Bachelor’s Degree
   

Work Experience:

• Required: Third Party Medical Billing Experience
   

• Required: EMAR System Knowledge
   

• Desired: 1-3 Years Pharmacy Experience
   

• Desired: 3 Years Call Center Experience

 
 Preferred Qualifications for Pharmacy Billing Representative:

• AS400, Frameworks or QS1, Computer Systems Experience
• 1+ years of experience in a pharmacy setting and with medical terminology
• Pharmacy Billing Representative licensure 

Benefits for Pharmacy Billing Representative:

• Immediate enrollment in Health Insurance
• Dental Insurance
• Life Insurance
• Employee Assistance Program (EAP)
• Access to Investment Accounts
• Career and educational tools within our Ingenovis ACT (Advocacy) Program

Pay Details: $19 /hour – $21/hour

Interested in being considered?
If you are interested in applying to this position, please click Apply Now for immediate consideration.

For additional consideration, please email a copy of your resume to James.Wallen@healthcaresupport.com with your phone number, the job title and location, and our recruiters will reach out.
Healthcare Support Staffing, LLC. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law. 
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