OverviewThe Pharmacy Billing Coordinator (PBC) ensures that all authorizations for drug therapy are completed in accordance with payer criteria and policy, in a timely manner, and prior to therapy initiation. This position will support the Fred Hutch retail specialty pharmacy team on claim rejections and interfacing with PBMs and the care team. All Pharmacy Technician III operational functions as required for the specific role. The PBC independently performs a variety of technical pharmacy billing functions to ensure accurate prescription billing. This position will work with stakeholders inside and outside of the pharmacy department to complete crucial and complex tasks relating to patient care, financial and billing practices, or regulatory compliance.
This is a full time role working Monday-Friday, 9:30 AM- 6:00 PM. This role will have the opportunity to work partially at our campus and remotely.
Responsibilities
- Performs complex and unique duties within the pharmacy department
- Interpret, evaluate, and summarize information and datasets of varying sizes
- Communicate effectively and professionally with stakeholder inside and outside of pharmacy department
- Develop and maintain internal (within Fred Hutch) and external relationships (such as vendors, payors, distributors)
- Work independently and within teams to complete tasks
- Documentation information or results in clear and concise ways
- Generate and present reports of tasks to Pharmacy Operations Manager or Director of Pharmacy
- Determine benefit limits and secure insurance approvals for specialty and high-cost medications
- Work closely with care team to communicate any coverage issues
- Evaluate patterns in denied claims taking corrective action and educating staff as needed
- Liaison with Patient Financial Services
- Serve as a resource to patients and staff regarding insurance and drug coverage questions
- Provide patient assistance program information and education to providers, patients and medical center staff
- Completing and submitting prior authorization forms and patient assistance applications
- Reprocessing denied or rejected third party claims
- Train and educate staff on pharmacy billing functions
- Participate in billing related meetings
- Retail pharmacy reconciliation and reporting
- Other pharmacy related duties in accordance with regulations under Washington State Pharmacy Quality Assurance Commission
Qualifications
Required:
- High school diploma or equivalent
- Current Washington state pharmacy technician certification
- WA State Pharmacy Technician License
- 2 years pharmacy technician experience
- Proficient in Microsoft suite
- Ability to communicate verbally in person, on the phone, and in writing in a clear, concise and professional manner
- Ability to perform basic pharmaceutical calculations
- Ability to use a mouse, navigate computer programs, enter data into computer systems accurately and efficiently
- Familiar with the generic names of drugs along with their basic indication
- Able to perform basic pharmaceutical calculations
- Review and correct discrepancies identified in daily, weekly and monthly billing reports
- Ability to work in a fast paced and complex environment
Preferred:
- Bachelors degree
- Attention to detail and accuracy documentation of information
- Ability to multitask and work efficiently in a dynamic work environment
- Ability to work effectively as a member of a team
- Experience with electronic medical records
- Previous experience in pharmacy billing
- Knowledge of CPT, ICD-10 and other medical terminology
- Knowledge of the health care environment and electronic medical records
- Participate in professional pharmacy organizations.
- Promote an image of service and goodwill to the patients, public, and hospital staff.
- Perform other related tasks as required.
The hourly pay range for this position is from $35.97 to $53.94 and pay offered will be based on experience and qualifications.
This is a full time role working Monday-Friday, 9:30 AM- 6:00 PM. This role will have the opportunity to work partially at our campus and remotely.Although Fred Hutch is not sponsoring most H-1B visas at this time, candidates who already hold an H-1B sponsored by another organization and are currently in the U.S. may be eligible for this position.Fred Hutchinson Cancer Center offers employees a comprehensive benefits package designed to enhance health, well-being, and financial security. Benefits include medical/vision, dental, flexible spending accounts, life, disability, retirement, family life support, employee assistance program, onsite health clinic, tuition reimbursement, paid vacation (12-22 days per year), paid sick leave (12-25 days per year), paid holidays (13 days per year), paid parental leave (up to 4 weeks).
