[Hiring] Data Entry @WES Health Systems

Role Description

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.

• Enter prescriptions into the pharmacy operating system for pharmacist approval.
• Answer and triage incoming phone calls in the department.
• Process prescription refill requests from facilities.
• Make calls to the facilities regarding medication inquiries.
• Review and investigate rejected third party claims; resolve/adjudicate as deemed necessary.
• Review and establish cycle fill batch claims from automatic dispensing machines per schedule for all assigned locations.
• Prepare and process third party prior authorization forms and follow-up as necessary.
• Process credits and returns.
• Provide superior customer service.

Qualifications

• Associates degree or equivalent experience preferred.
• Ability to answer multiple phone lines.
• Demonstrated proficiency with Microsoft Office programs including Excel, Word, and Outlook.
• Prior experience working with third party payors a plus.

Requirements

• 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.