Position:  Billing Coordinator - Specialty Pharmacy
Location:  Lakeland, FL
Job Id:  598
# of Openings:  1
 

At our company, we move fast, adapt quickly, and turn challenges into opportunities—all while keeping quality at the heart of everything we do. We believe that work should be a positive and respectful place, and that with the right mindset, anything is achievable. 

Our Vision:  

Fulfill the essential promise of pharmacy care and help people to live to their healthiest, happiest, and fullest potential. 

 Our Mission:  

To be the disruptive force that drives meaningful change within pharmacy services. 

Essential Duties & Responsibilities

  • Manages the adjudication inboxes
  • Assists with medical claims billing
  • Responsible for troubleshooting orders with a rejected status; refill too soon, increase/decrease of dose, duplicate claim, and eligibility issues.
  • Responsible for the reconciliation of the master claims queue
  • Assist with billing projects, ie. Member AR report, COGS, etc.
  • Ensures insurance information is accurate for correct adjudication.
  • Assists patients in the re-enrollment of copay cards and patient assistance plans
  • Communicates with patient assistance plans when necessary to obtain payment
  • Assists with the timely initiation and resolution of prior authorizations
  • Works with appropriate staff members to resolve claims issues
  • Follow and aid in enforcement of all company policies and procedures.
  • Respect and maintain confidentiality guidelines of HIPAA.
  • Responsible for other duties as assigned.

Education and Experience

  • High School Diploma or equivalent
  • Certified and Registered Pharmacy Technician, (Colorado) in good standing required
  • Registered with the State of Florida (Florida techs only) in good standing required, certification preferred
  • Previous Prior Authorization or Claims experience is preferred 

Knowledge, Skills, and Abilities

  • Demonstrates a high degree of personal responsibility regarding accuracy and quality of work.
  • Demonstrates ability to work effectively and maintain expected productivity.
  • Ensures accuracy of information being provided to Management for review.
  • Schedules own time based on priorities.
  • Demonstrates Excellent customer service and Professionalism
  • Ability to multi-task
  • Ability to communicate effectively, patiently, and courteously.
  • Ability to work in a high pace, stressful environment.
  • Should be independent and self-motivated.
  • Maintains a good attendance record.

Work Environment / Physical Demands

This position is in a typical office environment which requires prolonged sitting and standing in front of a computer.  In addition, this position requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment, including the operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients and employees. This position may be required to work long hours.  
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