Pharmacy Billing & Claims Specialist

Walgreens; Lexington (KY); On-site; USD 28,000 - 36,000; Full time

Job summary

Walgreens in Lexington, KY is seeking a Pharmacy Billing Technician to manage accurate billing and collections for third party and patient payments. You will submit invoices, verify authorizations, and ensure Medicare documentation is on file.

You’ll handle patient balances and assist with audits, while maintaining up-to-date PTCB/ExCPT credentials. Strong communication, attention to detail, and Excel proficiency are required to support accurate claims and timely reimbursements in a fast-paced

Qualifications

• High School diploma or equivalent.
• Pharmacy Technician license where required.
• Maintains PTCB or ExCPT certification as required.
• Experience communicating both verbally and in writing to diverse audiences.
• Experience providing customer service to internal and external customers.

Responsibilities

• Submit timely, accurate invoices to payer for products and services provided.
• Determine quantities and prices for billed products and services.
• Verify services/products are authorized and documentation is on file.
• Ensure Medicare documentation is received and submitted.
• Review reports to maximize generic substitution opportunities.
• Manage and collect patient balances prior to dispensing or per policy.
• Ensure all billing documentation is complete before claim submission.
• Process reimbursement checks/payments per policy.
• Review price modify logs and SDL claims.
• Review and resolve third party chargebacks in a timely manner.
• Assist with third party audits per policy.
• Process and file SDL claims per policy.
• Process prescription exceptions including prior authorizations and referrals, and copay assistance opportunities.
• Communicate with patients/providers about status.
• Maintain understanding of assistance programs enrollment and patient eligibility.
• Handle calls that do not require pharmacist attention.
• Coach staff on external billing practices.

Skills

Customer service

Verbal communication

Written communication

Attention to detail

Team coaching

Education

High School Diploma

Pharmacy Technician license

PTCB/ExCPT certification

Tools

MS Excel

Job description

Walgreens in Lexington, KY is seeking a Pharmacy Billing Technician to manage accurate billing and collections for third party and patient payments. You will submit invoices, verify authorizations, and ensure Medicare documentation is on file.

You’ll handle patient balances and assist with audits, while maintaining up-to-date PTCB/ExCPT credentials. Strong communication, attention to detail, and Excel proficiency are required to support accurate claims and timely reimbursements in a fast-paced