Billing Specialist: Pharmacy Claims & Coverage

Guardian Pharmacy, LLC

United States

On-site

USD 42,000 - 66,000

Full time

4 days ago

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Benefits offered by this job

401(k) with company match

Medical, Dental and Vision insurance

Company-paid Life Insurance

Long-Term Disability

Paid holidays & vacation

Job summary

Guardian Pharmacy of the Piedmont, a Guardian family location in Charlotte, NC, is seeking a Billing Specialist to process customer bills and insurance claims in a timely, accurate manner. The role supports daily and month-end billing, delivers excellent customer service to patients, caregivers, providers, and carriers.

The position requires high attention to detail, 1+ year of related experience, and familiarity with pharmacy billing.

Qualifications

High School Diploma or GED required.
Pharmacy Technician license/certification per state requirements; National Certification preferred (PTCB) may be required.
Pharmacy experience preferred.
Advanced computer skills; pharmacy information system experience preferred.
Ability to work independently and meet deadlines.
Great attention to detail and accuracy.

Responsibilities

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.
Enter and update patient/insurance information into billing system.
Maintain and audit patient files and documentation for audits and compliance.
Enter patient information into the pharmacy system and respond to billing inquiries.
Research and resolve patient billing issues regarding eligibility and coverage.
Run Medicare plan comparisons during open enrollment and special enrollment periods.
Review patient profiles to find options to save money for residents.
Process daily census, admissions, discharges, and room changes.
Process patient payments, returns, and credits; transmit credit card payments.