LTC Pharmacy Billing Specialist — Claims & Enrollment

Guardian Pharmacy, LLC; Kernersville (NC); Hybrid; USD 42,000 - 61,000; Full time

Benefits offered by this job

401(k) with company match

Health insurance (Full-Time)

Paid holidays and vacation

Life and disability insurance

Job summary

Southern Pharmacy Services, a member of the Guardian family, seeks a LTC Pharmacy Billing Specialist in Kernersville, NC. The role involves processing patient bills and insurance claims, and ensuring accurate, timely billing with responsive customer support to patients, caregivers, and providers.

Responsibilities include eligibility verification, data entry, and resolving billing issues. Schedule includes weekdays with rotating shifts, and weekend rotation is required.

Qualifications

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

Responsibilities

• Process patient billing and insurance claims accurately and timely.
• Enter patient and insurance information into billing system and maintain files.
• Respond to billing inquiries via phone or electronic communication.
• Perform prescription claims adjudication including handling rejections and prior authorizations.
• Rotate through departments to gain knowledge of workflows and ensure HIPAA compliance.

Skills

Attention to detail

Independent worker

Fast-paced environment

Strong communication

Education

Pharmacy Technician license/certification

Tools

Pharmacy software

Job description

Southern Pharmacy Services, a member of the Guardian family, seeks a LTC Pharmacy Billing Specialist in Kernersville, NC. The role involves processing patient bills and insurance claims, and ensuring accurate, timely billing with responsive customer support to patients, caregivers, and providers.

Responsibilities include eligibility verification, data entry, and resolving billing issues. Schedule includes weekdays with rotating shifts, and weekend rotation is required.