On-Site Pharmacy Billing Specialist, U.S. Claims Expert

Staffingly, Inc; Bogotá; On-site; COP 44,640,000 - 78,120,000; Full time

Job summary

Staffingly, Inc. is seeking an experienced Pharmacy Billing Specialist to support U.S. pharmacy operations serving long-term care and other healthcare facilities. This on-site role in Colombia requires hands-on prescription-billing experience and strong communication with pharmacy staff, facilities, PBMs and payers.

You will process claims, verify data, resolve rejections, and ensure accurate, compliant billing while coordinating with facility teams and maintaining HIPAA privacy standards.

Qualifications

• 3-5+ years hands-on prescription-billing experience with U.S. pharmacy claims.
• Experience with facility or hospital billing and communicating with pharmacy, payer or facility teams about billing issues.
• Knowledge of days' supply calculations, SIG codes and accurate prescription-data entry.

Responsibilities

• Process prescription claims and verify patient, prescriber, prescription and insurance information before submitting claims.
• Check coverage: confirm pharmacy benefits, eligibility and payer details; identify missing or conflicting information and flag coverage issues promptly.
• Resolve insurance rejections: investigate issues and reprocess within approved procedures.
• Coordinate payer follow-up: contact insurance plans and PBM help desks, document reference numbers and required actions.
• Calculate days' supply and enter data using SIG codes and approved directions.
• Support facility billing: research hospital or facility billing questions, reconcile account discrepancies and route charges to the correct account.
• Manage outstanding work: track rejected, unpaid or reversed claims, follow-up dates and escalation owners.
• Communicate clearly: handle billing calls professionally and provide accurate updates.
• Maintain privacy: follow HIPAA procedures and keep complete account notes.

Skills

Prescription billing

English communication

Attention to detail

Independent work

Job description

Staffingly, Inc. is seeking an experienced Pharmacy Billing Specialist to support U.S. pharmacy operations serving long-term care and other healthcare facilities. This on-site role in Colombia requires hands-on prescription-billing experience and strong communication with pharmacy staff, facilities, PBMs and payers.

You will process claims, verify data, resolve rejections, and ensure accurate, compliant billing while coordinating with facility teams and maintaining HIPAA privacy standards.