Pharmacy Billing Technician

Overview

Navajo Preference Employment Act

In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.

The primary purpose of this position is to process third party claims (billing and collection) on-line to pharmacy insurance carriers for the cost of pharmaceuticals furnished to patients who are covered by health insurance policies and have received treatment at the facility. Also, provides pharmacy claim processing for non-beneficiaries who receive medical services at the facility.

NECESSARY QUALIFICATIONS

Education:

High School Diploma or GED

Experience:

Minimum of one (1) year experience related to pharmaceutical terminology, billing, or general pharmacy operations

Other

Skills and Abilities:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:

• Positive working relationships with others
• Possession of high ethical standards and no history of complaints
• Reliable and dependable; reports to work as scheduled without excessive absences.
• Working effectively in team relationships
• Completion of and, above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC

The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Physical:

The work is primarily sedentary with the following physical requirements: ability to lift up to 10 pounds, walk for short periods of time, sit for long periods of time, stoop and pick up objects from the floor without restrictions, have full use of hands and arms for simple/firm grasping, fine manipulation, and use of keyboards, i.e., to operate office equipment such as computer, calculator, printer, fax, etc.

Must have the ability for prolonged use of near vision, color vision, depth perception, seeing in fine details, hearing normal speech, hearing overhead pages over a loudspeaker, and utilize a telephone. May occasionally need to use far vision.

Mental:

Exercises initiative and judgment in deviating from existing department or corporation practices to resolve billing issues/concerns. Work is reviewed for conformance to policies, procedures, and practices relating to billing practices. Must have prolonged ability to cope with high level of stress; make decisions under high pressure; cope with anger/fear/hostility of others in a calm way; manage altercations; concentrate; handle high degree of flexibility;

handle multiple priorities in stressful situation; demonstrate high degree of patience; adapt to shift work; and, work in areas that are close and crowded. May frequently need to work alone.

Environmental:

May occasionally be exposed to infectious disease, chemical agents, dust, fumes, gases, extremes in temperature or humidity, hazardous or moving equipment, unprotected heights, and loud noises.