Pharmacy Billing Specialist

Tuba City Regional Health Care Corporation; Tuba City (AZ); On-site; USD 35,000 - 54,000; Full time

Job summary

Tuba City Regional Health Care Corporation seeks a Pharmacy Billing Specialist to process third-party claims online for medications furnished to insured patients. The role requires a high school diploma or GED and at least one year of healthcare billing or pharmacy operations experience.

Responsibilities include handling on-line billing, verifying claim eligibility, securing prior authorizations, and coordinating with Patient Benefit Coordinators and Pharmacy staff.

Qualifications

• Education: High School Diploma or GED.
• Experience: Minimum of one (1) year related to pharmaceutical terminology, billing, or general pharmacy operations.
• Other qualifications: successful completion of background checks and fingerprint clearance, strong written and verbal communication.

Responsibilities

• Attempt to collect any self-payment(s)/copayment(s) amount owed by non-beneficiary patients at point of sale or via reporting.
• Ensure open professional communication with Pharmacy departments and support teams.
• Receive on-line billing reports and determine if prescriptions are billable per insurance guidelines.
• Familiar with Medicaid/Medicare/Part D and Commercial plans.
• Request and obtain prior authorizations as needed and submit required data.

Skills

Teamwork

Integrity

Reliability

Collaboration

Interview success

Background checks

Clearance checks

Documentation

Education

High School Diploma or GED

Job description

Tuba City Regional Health Care Corporation seeks a Pharmacy Billing Specialist to process third-party claims online for medications furnished to insured patients. The role requires a high school diploma or GED and at least one year of healthcare billing or pharmacy operations experience.

Responsibilities include handling on-line billing, verifying claim eligibility, securing prior authorizations, and coordinating with Patient Benefit Coordinators and Pharmacy staff.