Billing Coordinator - Specialty Pharmacy

WellDyne; Lakeland (FL); On-site; USD 36,000 - 52,000; Full time

Job summary

WellDyne is seeking a professional Pharmacy Technician to support adjudication and billing processes in a fast-paced office environment in Lakeland, FL. You will manage adjudication inboxes, assist with claims billing, and troubleshoot rejected orders while ensuring accurate insurance data.

The role requires a Florida-registered Pharmacy Technician with Colorado certification in good standing, High School diploma or equivalent, and a preference for prior authorization or claims experience.

Qualifications

• High School Diploma or equivalent.
• Colorado Pharmacy Technician certification in good standing required.
• Florida registration in good standing required; certification preferred.
• Prior Authorization or Claims experience preferred.

Responsibilities

• Manage adjudication inboxes.
• Assist with medical claims billing.
• Troubleshoot rejected orders and eligibility issues.
• Reconcile the master claims queue.
• Assist with billing projects (e.g., Member AR report, COGS).
• Ensure insurance information is accurate for adjudication.

Skills

Customer service

Attention to detail

Multi-tasking

Communication

Independence

Education

PHARMACY TECHNICIAN CERTIFICATION (Colorado)

Florida State Pharmacy Technician Registration

High School Diploma or equivalent

Job description

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.
• Assist 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.