Pharmacy/Medical Billing Specialist/Data Entry Technician
Boomer Solutions is part of the Guardian Pharmacy Services network and prides itself on its customer service. Each team member plays an integral part in the success of the pharmacy.
Assists in the billing, claims, and collections process as assigned.
- Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
- Leadership – ability to lead project teams to deadlines, while maintaining strong team orientation
- Relational – ability to build relationships with business unit management and become “trusted advisor”
- Strategy and Planning – ability to think ahead, plan and manage time efficiently
- Problem Solving – ability to analyze causes and solve problems at both a strategic and functional level
- Team Oriented – ability to work effectively and collaboratively with all team members
- Reprocess rejected claims to 3rd party providers by identifying why the claim was rejected and making any necessary corrections (prior authorization, new ID#, etc.)
- Answer incoming calls related to billing issues. Resolve issue or forward to appropriate authority as needed.
- Make outgoing calls to insurers, responsible parties and others to follow up on rejected claims and to garner accurate insurance information.
- Work collaboratively with co-workers to ensure all deadlines for department are met in an efficient manner
- Assist in the regular billing invoice production process
- Make preliminary collection calls for outstanding invoices. Assist in the production of collections letters
- File daily admits and make new folders as needed
- File all duplicate copies of private billing folders
- Copy checks for deposits and maintain all records accurately
- Complete prior authorization request forms
- Perform other duties and responsibilities as assigned
- Communicate and establish good relationship with facilities to obtain information as needed to assist with billing, patient set-up, & collections.
- Assist DFA with credit card payments, statement inquiries, audits, and collections.
- Assist with medication price quotes as needed.
- Other essential functions and duties may be assigned as needed
Education: High School Diploma or GED required
- 1+ years’ experience working as Licensed Pharmacy Technician, or 1+ years of related experience (advanced degree may substitute for experience)
- Advanced computer skills; pharmacy operations system experience preferred/required
- Ability to work independently and deliver to deadlines
- Ability to solve problems with minimal direction
- Great attention to detail and accuracy
- Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines
- Quality minded; motivated to seek out errors and inquire when something appears inaccurate
- Excellent interpersonal skills and ability to deal pleasantly with customers
Ability to work flexible hours; hours of operation are subject to change based on the needs of the pharmacy
Full-Time employees working 30+ hours per week are eligible to enroll in our comprehensive benefits package, which includes medical, dental, vision, short and long-term disability, life and supplemental life insurance, and PTO.
All employees are eligible to enroll in our company matched 401(k) plan