Pharmacy Tech/Biller

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.   

It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do — in the health of our patients, our loved ones, and our community.

Benefits Eligible

Full-Time Benefit Eligible

Work Shift

Day - 10 Hour Shift (United States of America)

Department

9553 Pharmacy-Retail

Under the direct supervision of the Pharmacist, the Pharmacy Technician will perform assigned tasks, within their scope, necessary for the operation of the pharmacy.

QUALIFICATIONS

License /Certification
Required: Pharmacy Technician registration with the California State Board of Pharmacy
Preferred: Certification as a Pharmacy Technician

Education
Preferred: High school diploma or equivalent

Experience
Preferred: One year pharmacy technician experience

JOB RESPONSIBILITIES
Essential

Keeps the pharmacy organized and clean. Maintains a friendly service-based attitude and work environment. Constantly strives to improve processes, productivity and quality.

Keeps other staff apprised and informed, assists in training and mentoring. Keeps the Outpatient Pharmacy Manager informed of any potential issues or areas of concern on an ongoing basis.

Answers telephone with courtesy. Takes messages as required and refers technical/clinical problems to the Pharmacist as appropriate or required by law.

Participates in Pharmacy staff meetings, training, and ongoing education.

Self-reports medication errors.

Addendum (essential for specific dept)

HOME INFUSION/PATIENT FINANCIAL SERVICES:

Maintains knowledge of compounds and medications given by the pharmacy. Maintains knowledge of KDHIP, CHC (SNF Medi-cal billing) and Medicare Part D billing.

Establishes and maintains patient charts, documentation, logs and files. Inputs information into computer, generates and uses reports to ensure smooth workflow of the pharmacy billing. Obtains TARs and SARs for billing the Medi-cal and CCS payers. Generates bills from computer system to bill payers.

Maintains complete and full knowledge of payer(s) assigned to ensure compliance of specific guidelines and rules, as well as ensuring Kaweah Health is being reimbursed by the payer in accordance with governmental or contract terms. Acts as a resource to Finance division management regarding the assigned payer.

Brings any reimbursement or compliance concerns to the attention of the Manager.

Utilizes computer systems and/or billing reports to review all patient registrations or admissions for demographic information, appropriate financial class, insurance company and plan and charges. 100% accuracy of this information is required to ensure proper recording of revenue, necessary authorizations are obtained, payer classification, correct billing of patient accounts and other statistical indicators. Brings any unresolved issues to the attention of their manager.

Audits unbilled reports for potential holdups of patient accounts. Works closely with pharmacy staff on DIF issues, insurance authorizations and documentation needed for billing.

Completes billing process. Ensures all charges are accurate and appropriate. Payer guidelines will be followed during the billing process. After billing has been completed, follows up in a timely manner with appropriate payers to ensure payments will be received.

Reviews and researches patient account credits and refunds as appropriate to patient and/or payer.

Receives all correspondence and inquiries related to patient accounts and payer contracts for which they are responsible. Answers mail and takes appropriate action within specified timeframe.

Bills any secondary payers, changes insurance plans or financial class accordingly and sends appropriate information to the secondary payer for co-pays, deductibles or denied services.

Reviews and works aging reports to identify any unpaid accounts. Works to ensure that days in accounts receivable are met, maintained and/or lowered. Maintains job productivity and quality standards on a consistent basis as established by division management.

Answers telephone wi