Billing Pharmacy Technician: Claims & Resident Advocate

Mmprx; Northern (KY); Hybrid; USD 38,000 - 55,000; Full time

Job summary

Mmprx is seeking a Billing Pharmacy Technician to handle accurate profile entry, claim processing, and follow-up on resident prescription billing in Northern Kentucky. You will communicate with community staff, residents, and POAs, while staying current on Medicare Part D, Medicaid, and commercial insurances.

The role emphasizes investigation, accuracy, and timely service, with responsibilities covering claims adjudication, prior authorizations, and monthly statement processing.

Qualifications

• Minimum of one year pharmacy billing experience.
• 2+ years pharmacy technician experience.
• Licensed, and in good standing, Pharmacy Technician.
• National Pharmacy Technician Certification (PTCB or NHA).
• FrameworkLTC / FrameworkECM knowledge a plus.
• Basic algebra and pharmaceutical math knowledge.
• Excellent verbal and written communication skills.
• Professional demeanor with customer service.
• Highly organized and detail-oriented.
• Able to multi-task and meet deadlines.

Responsibilities

• Billing, processing, and follow-up related to resident prescription billing.
• Communicating with community staff, residents, and POAs as needed.
• Researching and staying up to date on different insurance providers.
• Generate monthly statements, process payments, and reconcile third-party claims.
• Adjudicating insurance claims and troubleshooting rejected claims.
• Completing and/or following up on prior authorization forms.
• Data entry into FrameworkLTC and FrameworkECM systems.
• Providing customer service through phones and emails.
• Analyzing pre- and post-adjudication reports for training and compliance.
• Following core processes and maintaining accuracy.

Skills

Insurance billing

Medicare Part D knowledge

Medicaid knowledge

Commercial insurance knowledge

Data entry

Customer service

Attention to detail

Phone and email communication

Insurance provider research

Multi-tasking

Education

High Diploma or equivalent

National Certification (PTCB/NHA)

Pharmacy Technician License

Tools

FrameworkLTC / FrameworkECM

Job description

Mmprx is seeking a Billing Pharmacy Technician to handle accurate profile entry, claim processing, and follow-up on resident prescription billing in Northern Kentucky. You will communicate with community staff, residents, and POAs, while staying current on Medicare Part D, Medicaid, and commercial insurances.

The role emphasizes investigation, accuracy, and timely service, with responsibilities covering claims adjudication, prior authorizations, and monthly statement processing.