Pharmacy Billing Resolution Specialist

MedWiz Solutions, LLC; New York (NY); Hybrid; USD 52,000 - 76,000; Full time

Job summary

MedWiz Solutions, LLC in New York, NY seeks a Pharmacy Billing Dispute & Resolution Specialist to research and resolve customer billing inquiries, audits, disputes, and related account issues. The role serves as a liaison between Billing and Pharmacy Operations to validate charges and document resolutions.

You will review dispensing activity, deliveries, returns, and payer information to identify root causes of discrepancies and help prevent recurring issues while maintaining confidentiality and

Qualifications

• High school diploma or GED with 2+ years in pharmacy operations or PBM billing.
• License or registration as Pharmacy Technician where required.
• Strong analytical, investigative, and problem-solving skills.
• Proficient with Microsoft Excel and pharmacy billing systems.
• Ability to interpret medication documentation and payer information.

Responsibilities

• Review and resolve billing audits, disputes, and credit requests.
• Research dispensing records, deliveries, returns, census activity, and payer data.
• Determine supportability of disputed charges and issue credits or corrections.
• Identify root causes of billing discrepancies and recurring trends.
• Maintain clear documentation supporting findings and resolutions.
• Collaborate with Billing, Pharmacy Operations, Customer Service, Finance, and facilities.
• Track open issues through completion and follow up.
• Escalate high-dollar or unresolved discrepancies to management.
• Suggest process or training improvements to reduce future issues.
• Maintain confidentiality and HIPAA compliance.
• Attend as required and perform other duties.

Skills

Analytical skills

Investigative skills

Problem solving

Billing research

Communication

Attention to detail

Education

Associate degree or higher in Pharmacy or related field

Pharmacy technician registration/licensure

Bachelor's degree preferred

Tools

Microsoft Excel

Pharmacy billing systems

Job description

MedWiz Solutions, LLC in New York, NY seeks a Pharmacy Billing Dispute & Resolution Specialist to research and resolve customer billing inquiries, audits, disputes, and related account issues. The role serves as a liaison between Billing and Pharmacy Operations to validate charges and document resolutions.

You will review dispensing activity, deliveries, returns, and payer information to identify root causes of discrepancies and help prevent recurring issues while maintaining confidentiality and