Pharmacy Billing Resolution & Audit Specialist

MedWiz Mgmt LLC; Cherry Hill Township (NJ); On-site; USD 42,000 - 65,000; Full time

Job summary

MedWiz Mgmt LLC is seeking a Pharmacy Billing Dispute & Resolution Specialist in New Jersey to research and resolve billing discrepancies across dispensing, deliveries and payer information. The role partners with Billing and Pharmacy Operations to validate charges and determine appropriate credits or corrections.

Ideal candidates will have a high school diploma with 2+ years in pharmacy billing or related healthcare roles, plus strong analytical, Excel, and communication skills.

Qualifications

• High school diploma or GED required; 2+ years in pharmacy operations, PBM billing, or related healthcare environment.
• Pharmacy technician registration or licensure where required by state law.
• Strong analytical, investigative, organizational, and problem‑solving skills with ability to research and reconcile discrepancies.
• Intermediate proficiency with Microsoft Excel and healthcare systems used for billing and medication distribution.
• Ability to read medication documentation, reports, and communicate findings clearly.

Responsibilities

• Review and resolve customer billing audits, disputes, account discrepancies, and credit requests.
• Research dispensing records, deliveries, returns, census activity, payer information, and operational documentation.
• Determine whether disputed charges are supported and identify credits, adjustments, rebills, or corrections.
• Identify root causes of billing discrepancies and recurring trends.
• Maintain clear, accurate documentation supporting findings and resolutions.
• Collaborate with Billing, Pharmacy Operations, Customer Service, Finance, and facility reps to resolve issues.
• Track open billing issues through completion and follow up.
• Escalate high-dollar or unresolved discrepancies to management.
• Suggest process, system, or training improvements to reduce billing issues.
• Maintain confidentiality and HIPAA compliance.

Skills

Analytical skills

Investigative mindset

Organizational skills

Problem solving

Communication skills

Education

High school diploma or GED

Associate degree preferred

Certified Pharmacy Technician (CPhT)

Tools

Microsoft Excel

Pharmacy billing systems

Job description

MedWiz Mgmt LLC is seeking a Pharmacy Billing Dispute & Resolution Specialist in New Jersey to research and resolve billing discrepancies across dispensing, deliveries and payer information. The role partners with Billing and Pharmacy Operations to validate charges and determine appropriate credits or corrections.

Ideal candidates will have a high school diploma with 2+ years in pharmacy billing or related healthcare roles, plus strong analytical, Excel, and communication skills.