Repricing/ Pharmacy Bill Review Processor

Job Description:

AWPRx is seeking qualified candidates for a Repricing/Pharmacy Bill Review Processor. This position is a full time hourly position with AWPRx.  The responsibilities for this position include but are not limited to data entry, scanning, and pharmacy switch calls. AWPRx receives pharmacy bills from its clients in two ways, electronically and through the mail.  When bills are sent electronically to AWPRx a new repricing case is created by the electronic submission. When a paper pharmacy bill is sent directly to AWPRx, the bill is scanned and that scanning process will create a new repricing case.  The repricing/bill review agent will be able to access these repricing cases under our repricing open unassigned case view in Force Rx. The repricing process begins when a pharmacy bill review processor accepts a new repricing case, and begins entering the pharmacy bills into the AWPRx pharmacy bill review system.   Once the bill is entered, a pharmacy switch call is created. The repricing/pharmacy bill review processor with then call the pharmacy and switch the on-line billing to AWPRx.

Job Duties & Essential Functions:

• This position is within the AWPRx Repricing department and is responsible for entering data from prescription medication bills received from dispensing entities. The Repricing agent carefully reviews the supporting pharmacy bill documentation to ensure payment of the medical bill is correct based on state laws and AWPRx client protocol guide.
• Understanding and usage of the items below:
  • AWPRx Knowledge base ​
  • Repricing Comprehensive Article 
  • Protocol Guide
  • Glossary of Terms – A-F, G-P, Q-Z

Job Qualifications:

• Education:
  • REQUIRED: High School Diploma or GED equivalent
  • PREFERRED: Some college courses in accounting, business, or equivalent experience
• Experience:
  • REQUIRED: 3+ years of medical bill CPT coding experience
  • PREFERRED: CPC (Certified Professional Coder) certification
  • Preferred experience working with workers compensation medical bills
• Supervisory experience: 
  • Supervisory experience is preferred, but not required for the position.
• Other competencies or skills: N/A
• Compensation: This position is an hourly position that pays between $10.00 and $14.50 an hour.
• Background Checks/Licensing Requirements: N/A