Elderwood Home Care

Salary

Starting at 23.80 an Hour

Overview

The purpose of this role is to complete the initial data entry of prescriptions into the Pharmacy operating system to be reviewed and approved by a pharmacist. Provide administrative support to the billing department by processing and resolving pharmacy claims based on pharmacy delivery schedules, adding in insurance, tracking prior authorizations, and processing returned medications. Facilitate problem resolution by contacting clients’ insurance company, doctor office, and/or nursing facility. Answer and triage incoming calls into the department.

Responsibilities

Essential Job Functions

1. Enter prescriptions into the pharmacy operating system for pharmacist approval.

2. Answer and triage incoming phone calls in the department.

3. Process prescription refill request from facilities.

4. Make calls to the facilities regarding medication inquires.

5. Reviews and investigates rejected third party claims; resolves/adjudicates as deemed necessary.

6. Reviews and establishes cycle fill batch claims from automatic dispensing machines per schedule for

all assigned locations.

7. Prepares and processes third party prior authorization forms and follow-up as necessary.

8. Processes credits and returns.

9. Provides superior customer service.

10. Utilizes electronic timekeeping system as directed.

11. Arrives to work on time, regularly, and works as scheduled.

12. Recognizes and follows the dress code of the facility including wearing name tag at all times.

13. Follows policy and procedure regarding all electronic devices, computers, tablets, etc.

14. Supports and abides by Woodmark’s Mission, Vision, and Values.

15. Abides by Woodmark’s businesses code of conduct, compliance and HIPAA policies.

16. Performs other duties as assigned by supervisor, management staff or Administrator.

Qualifications

Educational Requirements and Qualifications

• Associates degree or equivalent experience preferred
• 3 years’ experience in pharmacy/third party billing, or pharmacy

technician experience preferred

• Ability to answer multiple phone line
• Experience in long term care billing preferred
• Pharmacy Technician experience in long term care, retail hospital

setting preferred

• Demonstrated proficiency with Microsoft Office programs including

Excel, Word and Outlook

• Prior experience working with third party payors a plus

Skills/Competencies

• Exceptional time management skills
• Highly organized with attention to detail
• Problem solver
• Ability to work autonomously as well as in a team setting
• Self-motivated
• Excellent customer service skills
• Excellent telephone communication skills
• This position requires regular interaction with residents, coworkers, visitors, and/or supervisors. In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level.

EOE Statement

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.