Job highlights
Identified by Google from the original job post
Qualifications
Must be a Registered Pharmacy Technician with the Florida Board of Pharmacy
Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
Relational – ability to build relationships with business unit management and become “trusted advisor.”
Strategy and Planning – ability to think ahead, plan and manage time efficiently
Problem Solving – ability to analyze causes and solve problems at functional level
Team Oriented – ability to work effectively and collaboratively with all team members
High School Diploma or GED required
1+ years of related experience
Ability to work independently and deliver to deadlines
Great attention to detail and accuracy
Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines
Quality minded; motivated to seek out errors and inquire about inaccuracies
Requires desk work in office environment
Ability to work flexible hours
Benefits
Comprehensive training provided side by side with training team
We offer full benefits including: Medical, Dental, Vision, Dental, Life Insurance, and a matching 401K option
Competitive hourly pay
Emotional well-being and physical health are important, which is why our employees receive a generous benefits package and a work culture that supports our core value of, “Treat others as you would like to be treated.”
Compensation Financial
Competitive pay
401(k) with up to 3.5% company match (1)
Family, Health Insurance Benefits (1), (2)
Multiple health plan options including copay (FSA-eligible) and HSA eligible plans
Wellness Incentive Program
Dental and Vision plans
Company-paid basic life, ADD and long-term disability coverage
Optional employee, spouse, and child life/ADD insurance
Optional accident, critical illness, and short-term disability coverage
Dependent Care Flexible Spending Accounts
Employee Assistance Program (EAP)
Time Off
Paid holidays and sick days
Generous vacation benefits based on years of service
Eligibility begins the first of the month following 30 days of employment
Responsibilities
Schedule: M-F +-5pm or 10-6pm and other Saturday 8-5pm
This role will be performed on-site at a closed-door pharmacy in Ormond Beach, FL
All patient interactions will be over the phone
Responsible for processing customer bills and insurance claims in an accurate and timely manner
This includes assisting with all daily and month-end billing functions, procedures and reporting
Provides excellent customer service to patients, caregivers, medical providers and insurance carriers
Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities
Reverify benefit coverage criteria as needed for claims follow up
Accurately enters and/or updates patient/insurance information into billing system
Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance
Accurately enter patient information into the pharmacy system
Provide assistance and timely response to all billing customer inquiries via phone or electronic communications
Research and resolve patient billing issues regarding insurance eligibility, coverage, and related benefits
Provide guidance and support to resident or responsible party by running Medicare plan comparisons during open enrollment and special enrollment periods
Proactively review patient profiles, drug regimens and insurance coverage to evaluate options to save resident money
Responsible for completion of daily census, admit, discharge, and room changes for the facilities assigned
Process patient payments, returns, and credits
Transmit individual credit card payments as needed
May pursue payment from delinquent accounts and make payment arrangements
Research, identify and organize requested audit documentation in timely manner
Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed
Make corrections as needed and rebill claims as necessary
Develop knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances)
Develop proficiency in the utilization of pharmacy information systems to meet operational needs and regulatory requirements
This includes using pharmacy systems to process prior authorizations, resolve rejections, produce various reports as necessary, and complete billing functions
Rotate through other departments to gain working/functional knowledge of other department workflows
Follow all applicable government regulations including HIPAA
Work as a collaborative team member to meet the service goals of the pharmacy
Other essential functions and duties may be assigned as needed
WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the job
The noise level in the work environment is usually low to moderate
Due to the collaborative nature of the business and the need to service customers, the employee must be able to interact effectively with others in an office environment, manage conflict, and handle stressful situations and deadlines
Job description
Ormond Beach, Florida, United States of America
Extraordinary Care. Extraordinary Careers.
With one of the nation’s largest, most innovative long-term care pharmacy services providers, there is no limit to the growth of your career.
Guardian Pharmacy of Daytona , a member of the Guardian family of pharmacies, has an exciting opportunity for you to join our rapidly growing team in Ormond Beach, Florida.
Why Guardian Pharmacy of Daytona? We’re reimagining medication management and transforming care.
Who We Are And What We’re About
Our core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.
We offer an opportunity to learn and grow your career in a fast-paced, diverse, and inclusive environment. If you are looking for a challenging, team-oriented environment in which you can put your expertise to work, then this is the place for you.
Details
• Schedule: M-F +-5pm or 10-6pm and other Saturday 8-5pm
• This role will be performed on-site at a closed-door pharmacy in Ormond Beach, FL. All patient interactions will be over the phone.
• Must be a Registered Pharmacy Technician with the Florida Board of Pharmacy.
We Offer
• Comprehensive training provided side by side with training team.
• We offer full benefits including: Medical, Dental, Vision, Dental, Life Insurance, and a matching 401K option.
• Competitive hourly pay.
Responsible for processing customer bills and insurance claims in an accurate and timely manner. This includes assisting with all daily and month-end billing functions, procedures and reporting. Provides excellent customer service to patients, caregivers, medical providers and insurance carriers.
Required
ATTRIBUTES REQUIRED:
• Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
• Relational – ability to build relationships with business unit management and become “trusted advisor.”
• Strategy and Planning – ability to think ahead, plan and manage time efficiently.
• Problem Solving – ability to analyze causes and solve problems at functional level.
• Team Oriented – ability to work effectively and collaboratively with all team members.
ESSENTIAL JOB FUNCTIONS (include The Following)
• Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities. Reverify benefit coverage criteria as needed for claims follow up. Accurately enters and/or updates patient/insurance information into billing system.
• Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance. Accurately enter patient information into the pharmacy system.
• Provide assistance and timely response to all billing customer inquiries via phone or electronic communications. Research and resolve patient billing issues regarding insurance eligibility, coverage, and related benefits.
• Provide guidance and support to resident or responsible party by running Medicare plan comparisons during open enrollment and special enrollment periods. Proactively review patient profiles, drug regimens and insurance coverage to evaluate options to save resident money.
• Responsible for completion of daily census, admit, discharge, and room changes for the facilities assigned.
• Process patient payments, returns, and credits. Transmit individual credit card payments as needed.
• May pursue payment from delinquent accounts and make payment arrangements.
• Research, identify and organize requested audit documentation in timely manner.
• Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed. Make corrections as needed and rebill claims as necessary.
• Develop knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances)
• Develop proficiency in the utilization of pharmacy information systems to meet operational needs and regulatory requirements. This includes using pharmacy systems to process prior authorizations, resolve rejections, produce various reports as necessary, and complete billing functions.
• Rotate through other departments to gain working/functional knowledge of other department workflows.
• Follow all applicable government regulations including HIPAA.
• Work as a collaborative team member to meet the service goals of the pharmacy.
• Other essential functions and duties may be assigned as needed.
Education And/Or Certifications
• High School Diploma or GED required.
• Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required (pharmacy specific).
Skills And Qualifications
• 1+ years of related experience
• Advanced computer skills; pharmacy information system experience preferred.
• Ability to work independently and deliver to deadlines.
• Great attention to detail and accuracy
• Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines
• Quality minded; motivated to seek out errors and inquire about inaccuracies.
WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the job.
• The noise level in the work environment is usually low to moderate.
• Due to the collaborative nature of the business and the need to service customers, the employee must be able to interact effectively with others in an office environment, manage conflict, and handle stressful situations and deadlines.
• Requires desk work in office environment.
• Ability to work flexible hours.
What We Offer
Emotional well-being and physical health are important, which is why our employees receive a generous benefits package and a work culture that supports our core value of, “Treat others as you would like to be treated.”
Compensation Financial
• Competitive pay
• 401(k) with up to 3.5% company match (1)
Family, Health Insurance Benefits (1), (2)
• Multiple health plan options including copay (FSA-eligible) and HSA eligible plans
• Wellness Incentive Program
• Dental and Vision plans
• Company-paid basic life, ADD and long-term disability coverage
• Optional employee, spouse, and child life/ADD insurance
• Optional accident, critical illness, and short-term disability coverage
• Dependent Care Flexible Spending Accounts
• Employee Assistance Program (EAP)
Time Off
• Paid holidays and sick days
• Generous vacation benefits based on years of service
• Eligibility begins the first of the month following 30 days of employment
• Full-time employees only, excluding EAP which is available to all Guardian employees
The Guardian Difference
Our clients require pharmacy services that aren’t “cookie cutter.” That’s why every Guardian pharmacy is locally operated and empowered with the autonomy to tailor their business to meet their clients’ needs.
Our corporate support offices, based in Atlanta, Ga., provide services such as human resources, business intelligence, legal, and marketing to promote the success of each Guardian location.
Regardless of your role at Guardian, your voice and talents matter. Because healthcare is an ever-changing industry, we encourage innovative thinking, intellectual curiosity, and diverse viewpoints to ensure we stay competitive in today’s dynamic business environment.
At Guardian, we are dedicated to fostering and advancing a diverse and inclusive workforce.
Join us to discover what your best work truly looks like.
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