Pharmacy Billing & Claims Specialist

Walgreens; Houston (TX); On-site; USD 28,000 - 36,000; Full time

Job summary

Walgreens in Houston, TX is seeking a Pharmacy Billing Specialist to ensure accurate billing and timely collection of third-party and patient payments for products and services rendered.

You will submit invoices, verify quantities, prices, and authorizations while maintaining documentation and supporting audits. This role emphasizes patient communication and adherence to company policy with a focus on timely filing and reimbursement.

Qualifications

• Strong communication to diverse audiences, including internal teams and external payers.
• Commitment to high-quality customer service and satisfaction.
• Ability to document and report accurately in writing and verbally.

Responsibilities

• Submit timely, accurate invoices to payer for products and services provided.
• Determine quantities and prices for billed products and services.
• Verify authorizations and required documentation is on file.
• Ensure Medicare documentation is collected and submitted.
• Review reports to maximize substitution opportunities.
• Manage and collect patient balances prior to dispensing, or per policy.
• Ensure billing documentation is complete before claim submission.
• Process reimbursement and payments per policy.
• Review price modify logs and SDL claims.
• Handle third party chargebacks timely and assist with audits.
• Process and file SDL claims per policy.
• Process prescription exceptions including prior authorizations and referrals.

Skills

Communication skills

Customer service

Verbal & written communication

Education

High School Diploma or equivalent

Pharmacy Technician license

PTCB or ExCPT certification

Job description

Walgreens in Houston, TX is seeking a Pharmacy Billing Specialist to ensure accurate billing and timely collection of third-party and patient payments for products and services rendered.

You will submit invoices, verify quantities, prices, and authorizations while maintaining documentation and supporting audits. This role emphasizes patient communication and adherence to company policy with a focus on timely filing and reimbursement.