Licensed Pharmacy Technician - Claims & Billing Specialist

Kalamazoo Long Term Care Pharmacy; Bessemer Township (MI); On-site; USD 51,577,000 - 63,039,000; Full time

Benefits offered by this job

Medical Insurance

Vision Insurance

Dental Insurance

401(k) Matching

Life Insurance (Employer-Funded)

Financial Counseling

Mental Health EAP

CE Credits (Employer-Paid)

PTO and Sick Time

Job summary

Princing's LTC Pharmacy in Saginaw, MI is seeking a detail-oriented Licensed Pharmacy Technician to join our team as a Claims Technician. The role focuses on processing prescription claims and ensuring timely, accurate billing so long-term care patients receive their medications without delays.

The Claims Technician will manage billing queues, assist with prior authorization needs, and collaborate with providers and insurance payers to resolve issues and maintain efficient claims processing.

Qualifications

• High school diploma or equivalent.
• Active State of Michigan Pharmacy Technician license.
• 1–2 years of pharmacy billing or healthcare claims processing experience preferred.
• Experience with FrameworkLTC or QS/1 preferred.
• Working knowledge of Medicaid, Medicare Part D, and private insurance.
• Strong problem-solving skills, particularly with claim rejections and prior authorization issues.
• Excellent attention to detail and accuracy.
• Strong communication and time management skills.
• Ability to multitask and prioritize in a fast-paced environment.
• Ability to maintain strict patient confidentiality.

Responsibilities

• Process and submit daily prescription claims in real time.
• Monitor and clear billing queues to maintain an efficient workflow.
• Manage recurring billing cycles for long-term care and institutional patients.
• Process accurate bulk claims related to cycle fill schedules.
• Create, monitor, and manage billing batches within pharmacy systems; review batch exceptions and resolve billing issues.
• Identify rejected claims and assist with the prior authorization process.
• Work with providers and insurance payers to obtain prior authorization documentation and reprocess claims.
• Update billing records when patients are admitted, discharged, or experience insurance changes.
• Prioritize first-dose and urgent claims to support timely patient care.
• Communicate and collaborate with the pharmacy team regarding time-sensitive billing issues.
• Perform additional duties as assigned

Skills

Attention to detail

Time management

Communication

Multitasking

Problem-solving

Education

High school diploma

Active Michigan Pharmacy Technician license

Tools

FrameworkLTC

QS/1

Job description

Princing's LTC Pharmacy in Saginaw, MI is seeking a detail-oriented Licensed Pharmacy Technician to join our team as a Claims Technician. The role focuses on processing prescription claims and ensuring timely, accurate billing so long-term care patients receive their medications without delays.

The Claims Technician will manage billing queues, assist with prior authorization needs, and collaborate with providers and insurance payers to resolve issues and maintain efficient claims processing.