Billing Specialist - On-Site Pharmacy Claims & Patient Support

Guardian Pharmacy; Grand Rapids (MI); On-site; USD 28,000 - 33,000; Full time

Benefits offered by this job

401(k) with company match

Medical, Dental and Vision

Paid holidays & sick days

Generous vacation benefits

Employee Assistance Program (EAP)

Job summary

Guardian Pharmacy of Michigan in Grand Rapids, MI, is seeking a Pharmacy Billing Specialist to join our on-site team. You will process patient billing and insurance claims, verify eligibility, and provide excellent service to patients, caregivers, providers, and carriers.

You will handle daily billing tasks, collaborate with diverse teams, and ensure accuracy and regulatory compliance in a fast-paced environment while supporting residents and facilities we serve.

Qualifications

• High School Diploma or GED required.
• Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required.

Responsibilities

• Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities.
• Maintain and audit patient files and documentation to defend third party audits and ensure compliance.
• Provide timely responses to billing inquiries via phone or electronic communication.
• Run Medicare plan comparisons during open enrollment and assess options to save residents money.
• Process daily census, admissions, discharges, and room changes for assigned facilities.
• Process patient payments, returns, and credits; transmit credit card payments as needed.
• Research and organize audit documentation for requested items.
• Adjudicate prescription claims and coordinate with insurers on rejections or prior authorizations.

Skills

Billing & claims

Customer service

HIPAA compliance

Attention to detail

Team player

Education

High School Diploma or GED

Pharmacy Technician license/certification

Tools

Pharmacy information system

Job description

Guardian Pharmacy of Michigan in Grand Rapids, MI, is seeking a Pharmacy Billing Specialist to join our on-site team. You will process patient billing and insurance claims, verify eligibility, and provide excellent service to patients, caregivers, providers, and carriers.

You will handle daily billing tasks, collaborate with diverse teams, and ensure accuracy and regulatory compliance in a fast-paced environment while supporting residents and facilities we serve.