Pharmacy Billing & Financial Operations Specialist

Advocate Health; Winston-Salem (NC); On-site; USD 42,000 - 66,000; Full time

Job summary

Advocate Health in Winston-Salem, NC, seeks a full-time Pharmacy Billing Specialist to join our on-site Finance team. You will reconcile claims, manage receivables, review EOBs, and support Medicare Part B documentation and audits.

The role emphasizes accuracy, attention to detail, and the ability to work with payers, vendors, and pharmacy staff. Experience in pharmacy billing or healthcare accounting is preferred, with proficiency in Excel and standard office software.

Qualifications

• High school diploma or equivalent.
• Typically 2 years’ experience required.
• Pharmacy Technician experience preferred.
• Financial analyst or staff accounting experience preferred.

Responsibilities

• Reconciles pharmacy claims to third party and interdepartmental payments. Tracks and reports payments, receivables, and bad debt.
• Reviews EOBs and reconciles bank deposits.
• Manages documentation and assists in pharmacy financial assistance program processes.
• Utilizes payer and banking portals to research payment denials and exceptions.
• Contacts third party payers to resolve issues resulting in denials/underpayments.
• Responds to payer requests for supporting documentation.
• Communicates payment and remittance information to external billing agencies.
• Submits manual claims as necessary and monitors claim status for proper payment.
• Ensures Medicare Part B documentation is completed and maintained for compliant billing.
• Provides billing compliance training for pharmacy staff.
• Compiles supporting documentation in response to payer audits.
• Manages patient billing and receivables; generates statements and processes payments.
• Administers outpatient pharmacy charity care and extended payment programs.
• Answers pharmacy billing phone line and assists patients with questions.
• Assists with payer credentialing; compiles and submits necessary documentation.
• Submits pharmacy invoices for payment and ensures vendors are paid timely.
• Maintains financial data and generates monthly reports for month-end entries.
• Produces ad hoc management reports as necessary.
• Seeks ways to minimize waste and reduce costs within budget guidelines.

Skills

Mathematical accuracy

Multitasking

Self-motivated

Attention to detail

Team oriented

Education

High school diploma or equivalent

2 years’ experience

Pharmacy Technician experience preferred

Financial analyst or staff accounting experience preferred

Tools

Microsoft Excel

Microsoft Word

Outlook

Adobe Pro

Job description

Advocate Health in Winston-Salem, NC, seeks a full-time Pharmacy Billing Specialist to join our on-site Finance team. You will reconcile claims, manage receivables, review EOBs, and support Medicare Part B documentation and audits.

The role emphasizes accuracy, attention to detail, and the ability to work with payers, vendors, and pharmacy staff. Experience in pharmacy billing or healthcare accounting is preferred, with proficiency in Excel and standard office software.