Pharmacy Billing Specialist

Overview:

Medicines are powerful—they can prevent and heal disease, but they can also be costly, ineffective or even harmful if not prescribed and taken correctly. The team at Mosaic Pharmacy Service is helping people get more from their medicines™. 

Mosaic Pharmacy Service provides comprehensive pharmacy care to medically complex and vulnerable seniors. We provide a patient-focused, pharmacist-driven care model in collaboration with health systems, assisted living facilities and health plans. Our goal is to help our patients feel better about the medications they take every day by simplifying medication regimens, improving adherence, and driving positive outcomes. Mosaic is looking for caring, motivated, and creative individuals to join our team for an innovative new career opportunity.

Job Profile

The Pharmacy Billing Specialist will be accountable for helping our patients navigate the billing and collections process.  They will bridge the gap between our clinical and financial teams by working directly with patients and insurers to help answer questions, investigate concerns, and ultimately drive collections.  Under the guidance of our Pharmacist-in-Charge, the role will involve inbound and outbound calls to patients, provider offices, and insurance companies to collect needed information, update appropriate systems, communicate with correct parties, and reconcile billing/claims as necessary.

Key responsibilities include the following: 

• Provide top-of-the-line customer service, both internally and externally, ensuring that all parties involved have an exceptional experience
• Identify and resolve patient billing concerns promptly
• Collaborate with the team through our CRM platform, e-mail, phone, and in-person

• Answer routine inquiries from patients regarding health plan drug coverage, prices, and related issues
• Perform various collection actions including contacting patients by phone as well as correcting and resubmitting claims to third party payers
• Contact insurance companies and/or PBMs to resolve claims issues
• Identify situations when patients should speak with a pharmacist and appropriately triages to the pharmacist
• Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations
• Perform other tasks as assigned 
• All duties to be performed onsite at our Sterling, VA pharmacy

Qualifications:

• Active Virginia pharmacy technician license required
• Experience in pharmacy billing and claims including contacting insurance companies and PBMs
• Strong track record of reliability with excellent customer service skills
• Team-oriented with the ability to collaborate with others to find solutions to problems
  
• Experience with managed care, retail, mail order or LTC pharmacy data entry and pharmacy software preferred
• Knowledge of pharmacy laws and federal and state regulations concerning patient care
• Strong communication (written and verbal) skills
• Strong attention to detail
• Bilingual Spanish fluency a plus

 Benefits:

• Medical, Dental, Vision, 401K, generous PTO, and stock options
• Signing bonus of $500 if 0-5 years of pharmacy technician experience (paid after 3 months of employment)
• Signing bonus of $1000 if 5+ years of pharmacy technician experience (paid after 3 months of employment)
• Full-time Monday-Friday role with no weekends or nights

 Here’s why we think you’ll enjoy working with us: 

• The Mosaic team is widely heralded for its expertise, creativity, and collaborative approach to work.  The quality of our people has been—and always will be—the key to our success
• You’ll make a meaningful impact on improving the health and wellness of complex and vulnerable patients