Providence Health & Services Billing Specialist - Pharmacy Technician in Spokane, Washington
Providence is calling a Billing Specialist, Pharmacy Technician (Day Shift, 1.0 FTE, 40 hours per week) to Providence Infusion and Pharmacy Services in Spokane, Washington. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all - especially those who are poor and vulnerable.
In this position you will:
Processes claims via adjudication specific to patient health insurance benefits or Medicare Part D Benefits and assess denied or partially paid claims to ensure that reprocessing occurs within billing allowance for full reimbursement.
Coordinates and reviews patient accounts to verify accurate pharmacy filling, insurance reimbursement, and appropriate receipt of payments.
Retrieves/reviews insurance authorizations for covered services to ensure pharmacy medications and associated services are reimbursed.
Validates medication, enteral, and clinical visit (i.e., RN, RD) delivery tickets for accuracy, including but not limited to, correct billing units, dates of service, per diem codes, and/or waste. Validates completeness and accuracy of pharmacy work orders including utilization of appropriate NDC codes, waste documentation, fill number, and sign-offs. Changes status of delivery tickets to a verified ready-to-bill status as appropriate.
Coordinates, reviews, investigates and assists patients in co-pay assistance programs, charity programs, foundation support and processes these claims according to current guidelines. Communicates and is a resource for caregiver teams around updates, changes, and/or new support programs available for patients.
Serves as a billing/reimbursement resource and problem solver to the business finance team, core leaders, pharmacists, pharmacy technicians, physicians, and provider relations staff.
Develops written (including resources, training documents, etc.) and/or verbal communication for pharmacists, technicians, and other caregivers to update any changes in the billing/reimbursement/charge capture process.
Maintains current knowledge of contracts and pricing, including the medical coverage criteria and requirements of individual commercial and government payers. Addresses customer and referral source concerns regarding insurance coverage criteria issues.
Ensures all processes conform to current Medicare, Medicaid, TJC (or other accreditation organizations), and payer-specific guidelines.
Required qualifications for this position include:
High School Diploma or GED
Current Washington State Board of Pharmacy Technician license
Certification from the Pharmacy Technician Certification Board (PTCB)
2 to 3 years of experience in health care or pharmacy billing, collections or medical claims processing
2 to 3 years of experience as a pharmacy technician in a specialty setting (e.g. Long Term Care, Infusion or Specialty Pharmacy) or three years pharmacy technician experience in an outpatient pharmacy setting
Experience with computers including proficiency in data entry, spreadsheet creation, data tables, workflow diagrams, flow sheets, letter writing, template creation, and report generation
Preferred qualifications for this position include:
Experience with insurance/data inquiry/transmitting systems
Experience using electronic medical records and pharmacy software
Knowledge of Intravenous access care, Intravenous flush protocols, Intravenous pumps, and Intravenous medication stability and concentrations
Knowledge of Joint Commission standards (JCAHO) or other accreditation organizations
Knowledge of home health, hospice, and home medical equipment services
About the ministry you will serve.
Providence Infusion and Pharmacy Services in Spokane, Washington provides home and ambulatory infusion services to pediatric and adult patients in Washington, Idaho, Montana, and Oregon. Patient quality/safety, satisfaction, and positive clinical outcomes are top priorities. Our services include infusion therapy and enteral/parenteral services to patients in their homes or in our Ambulatory Infusion Suites (AIS)., disease management, specialized infusion services, and clinical nurse, pharmacist, and dietitian consulting and support.
Spokane, WA is in the heart of the Inland Northwest, offering four seasons that include winter snow, cool springs, warm summers and mild fall temperatures. Outdoor recreational are numerous and include fishing, hiking, biking, camping, skiing, hunting, golfing, and boating. Spokane is located about 30 miles from Idaho and is within a few hour drive of Seattle, Portland, Missoula, Canada, or the Washington and Oregon coasts. Spokane is a vibrant community that is easy to navigate, has short commute times, and offers variety of sporting events, concerts, shopping, dining, and entertainment experience.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Billing / Insurance
Req ID: 187883