Pharmacy Billing & Claims Specialist

Walgreens; Glendale (CA); On-site; USD 30,000 - 40,000; Full time

Job summary

Walgreens in Glendale, CA is seeking a Billing Specialist to manage accurate billing and collection of third-party and patient payments for products and services rendered. You will submit invoices, verify quantities/prices, and ensure documentation is complete before claim submission.

The role requires a High School diploma, pharmacy technician license (where required) and PTCB/ExCPT certification, plus experience communicating with payers, patients, and providers.

Qualifications

• High School Diploma or equivalent.
• Pharmacy Technician license (where required).
• PTCB or ExCPT certification through approved program.
• Experience communicating verbally and in writing to varied audiences.
• Experience providing customer service to internal and external customers.

Responsibilities

• Submit timely, accurate invoices to payer for products and services provided.
• Correctly determine quantities and prices for products and services billed.
• Verify services and products are correctly authorized and required documentation is on file.
• Ensure all Medicare documentation is received from the medical provider and submitted.
• Review reports to maximize generic substitution opportunities.
• Manage and collect patient balances prior to prescription dispensing, or per policy.
• Ensure all required billing documentation is completed prior to claim submission.
• Process reimbursement checks/payments in accordance with policy.
• Review price modify logs and SDL claims.
• Review, research and resolve all third party chargebacks promptly.
• Assist with third party audits per policy.
• Process and file all SDL claims per policy.
• Handle prescription exceptions including prior authorizations and referrals, and copay assistance opportunities.
• Communicate with patients/providers regarding referral/prescription status.
• Assist patients with enrollment in assistance programs and verify eligibility.
• Handle calls not requiring pharmacist attention, including to physicians and payers.
• Coach staff on external billing practices like third party adjudications.

Skills

Billing accuracy

Communication

Customer service

Data entry

Education

High School Diploma or equivalent

Pharmacy Technician license

PTCB or ExCPT certification

Tools

MS Excel

Job description

Walgreens in Glendale, CA is seeking a Billing Specialist to manage accurate billing and collection of third-party and patient payments for products and services rendered. You will submit invoices, verify quantities/prices, and ensure documentation is complete before claim submission.

The role requires a High School diploma, pharmacy technician license (where required) and PTCB/ExCPT certification, plus experience communicating with payers, patients, and providers.