Pharmacy Billing Clerk

Nexus HR; Sacramento (CA); On-site; USD 25,000 - 30,000; Full time

Benefits offered by this job

Dental, Vision, and Health Insurance

PTO and Sick Leave

401k

Job summary

Nexus HR is seeking a Pharmacy Billing Clerk in Sacramento, CA to manage billing operations in a fast-paced long-term care and assisted living pharmacy.

Responsibilities include submitting insurance claims, posting payments, balancing accounts, and communicating with patients and facility staff. Requires 1 year of pharmacy billing experience, HS diploma, and proficiency with IPS, QS1, and Microsoft Office; strong data-entry and reconciliation skills are essential.

Qualifications

• High school diploma or equivalent; Associate degree preferred.
• Minimum 1 year of pharmacy billing experience.
• In-depth knowledge of insurance requirements.
• Proficiency in IPS, QS1, and Microsoft Suite; or comparable software/s.
• Excellent analytical, organizational, and problem-solving skills.
• Strong communication with healthcare providers and facility staff.
• High attention to detail and accuracy in data entry and financial reconciliation.

Responsibilities

• Accurately prepare, submit, and track insurance claims for medications dispensed to long-term care and institutional patients.
• Verify insurance eligibility, prepare and submit claims, and post payments accurately.
• Generate statements of accounts and follow up on unpaid balances with patients and facility staff.
• Handle billing inquiries, explain charges, and collect payments professionally.
• Resolve denied claims by coordinating with insurance providers or PBMs.
• Maintain accurate billing records and prepare reports as needed.
• Perform general administrative tasks, including MS Word & Excel, email correspondence, and managing office supplies.

Skills

Analytical skills

Organizational skills

Problem solving

Communication

Attention to detail

Data entry

Education

Associate degree in healthcare administration

High school diploma or equivalent

Tools

IPS - Intelligent Pharmacy Software

QS1

Microsoft Office

Job description

Pharmacy Billing Clerk - Sacramento, CA

Compensation: $18 - $22 Hourly

Overview:

Nexus HR is looking for a Pharmacy Billing Clerk with strong experience working in a fast-paced Long-Term Care and Assisted Living pharmacy in Sacramento.

About the Job:

The Pharmacy Billing Clerk is responsible for efficiently managing billing operations. This role involves processing claims, posting payments, following up on balances, and maintaining strong communication with patients and facility staff.

Duties and Responsibilities:

• Accurately prepare, submit, and track insurance claims for medications dispensed to long-term care and institutional patients.
• Verify insurance eligibility, prepare and submit claims, and post payments accurately.
• Generate statements of accounts and follow up on unpaid balances with patients and facility staff.
• Handle billing inquiries, explain charges, and collect payments professionally.
• Resolve denied claims by coordinating with insurance providers or PBMs.
• Maintain accurate billing records and prepare reports as needed.
• Perform general administrative tasks, including MS Word & Excel, email correspondence, and managing office supplies.

Qualifications:

• High school diploma or equivalent required; Associate degree in healthcare administration, accounting, or related field preferred.
• Minimum 1 year of pharmacy billing.
• In-depth knowledge of insurance requirements.
• Strong proficiency in Pharmacy Management Software (IPS - Intelligent Pharmacy Software), Point of Sale (QS1), and Microsoft Suite; or comparable software/s.
• Excellent analytical, organizational, and problem-solving skills.
• Strong communication skills with the ability to interact professionally with healthcare providers and facility staff.
• High attention to detail and accuracy in data entry and financial reconciliation.

Qualifications:

• Dental, Vision, and Health Insurance
• PTO and Sick Leave
• 401k