Pharmacy Billing & Claims Specialist — Detail-Oriented Pro

Guardian Pharmacy; Cedar Rapids (IA); On-site; USD 40,000 - 60,000; Full time

Job summary

Right Dose Pharmacy in Cedar Rapids, IA is seeking a billing specialist to process customer bills and insurance claims accurately and on time. You will support daily and month-end billing functions and provide excellent service to patients, caregivers, medical providers, and insurers.

As part of the Guardian family of pharmacies, you will join a fast-growing team focused on accurate billing, patient advocacy, and streamlined revenue cycle processes in a dynamic healthcare environment.

Qualifications

• Intrinsic drive to excel with company values.
• Ability to build relationships with management and become “trusted advisor.”
• Ability to think ahead, plan and manage time efficiently.
• Ability to analyze causes and solve problems at functional level.
• Ability to work effectively and collaboratively with all team members.

Responsibilities

• Research and establish patient eligibility coverage with insurance providers and update patient/insurance information in billing system.
• Maintain and audit patient files and documentation to defend third party audits and ensure payer compliance.
• Provide timely responses to billing inquiries via phone or electronic communications and resolve issues.
• Run Medicare plan comparisons during open enrollment to help residents save money.
• Manage daily census, admit, discharge, and room changes for facilities.
• Process patient payments, returns, and credits; transmit credit card payments as needed.
• Pursue payment from delinquent accounts and arrange payment plans.
• Organize requested audit documentation for timely responses.
• Adjudicate prescription claims and communicate with insurers about rejected claims.

Skills

Work Ethic/Integrity

Relational

Strategy and Planning

Problem Solving

Team Oriented

Job description

Right Dose Pharmacy in Cedar Rapids, IA is seeking a billing specialist to process customer bills and insurance claims accurately and on time. You will support daily and month-end billing functions and provide excellent service to patients, caregivers, medical providers, and insurers.

As part of the Guardian family of pharmacies, you will join a fast-growing team focused on accurate billing, patient advocacy, and streamlined revenue cycle processes in a dynamic healthcare environment.