Pharmacy Billing & Insurance Specialist

Guardian Pharmacy

Arlington (TX)

On-site

USD 38,000 - 52,000

Full time

14 days+

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Job summary

Guardian Pharmacy is seeking a detail-oriented Billing Specialist in Arlington, TX to process patient bills and insurance claims accurately and timely. You will support daily and month-end billing functions, and provide excellent service to patients, caregivers, medical providers, and insurers.

The role emphasizes HIPAA compliance, precise data entry, and effective communication within a collaborative team.

Qualifications

1+ years of related experience.
Advanced computer skills; pharmacy information system experience preferred.
Ability to work independently and meet deadlines.
Great attention to detail and accuracy.
Able to work in a fast-paced, team-oriented environment handling multiple tasks.
Quality minded; motivated to seek out errors.

Responsibilities

Research and establish patient eligibility coverage with insurance providers.
Maintain and audit patient files for third-party audits and compliance.
Provide timely responses to billing inquiries via phone or electronic communications.
Run Medicare plan comparisons during open enrollment and review patient profiles for cost savings.
Complete daily census, admit, discharge, and room changes for facilities.
Process patient payments, returns, and credits; transmit credit card payments.
Pursue payments from delinquent accounts and arrange payment plans.
Research and organize requested audit documentation promptly.
Perform prescription claims adjudication and rebill as needed with insurance.
Develop knowledge of Medicare/Medicaid and PDPs billing requirements.
Utilize pharmacy information systems to process prior authorizations and generate reports.
Rotate through other departments to gain cross-functional knowledge.
Follow HIPAA regulations and work as a team member to meet service goals.