Pharmacy Billing Specialist: Claims, Coverage & Payments

Guardian Pharmacy, LLC; Grand Rapids (MI); On-site; USD 32,000 - 33,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) with company match

Job summary

Guardian Pharmacy of Michigan is seeking a Billing Specialist III to join our Grand Rapids, MI team. You will handle patient eligibility with insurance providers, bill processing, and customer inquiries with a focus on accuracy and timely reporting.

The role emphasizes prior authorizations, payer interactions, and maintaining compliance with HIPAA while supporting daily billing operations in a fast-paced environment.

Qualifications

• High School Diploma or GED required.
• Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required.

Responsibilities

• Process patient eligibility coverage with insurance providers and update billing system.
• Enter patient information into the pharmacy system and maintain patient files.
• Respond to billing inquiries via phone or electronic communications and resolve issues.
• Run Medicare plan comparisons during open enrollment and evaluate options to save residents money.
• Complete daily census, admit, discharge, and room changes for facilities assigned.
• Process patient payments, returns, and credits; transmit credit card payments as needed.
• Research, identify, and organize requested audit documentation promptly.

Skills

Work Ethic

Relational

Strategy & Planning

Problem Solving

Team Oriented

Education

High School Diploma or GED

Pharmacy Technician license/certification (state req)

Tools

Pharmacy information system

Job description

Guardian Pharmacy of Michigan is seeking a Billing Specialist III to join our Grand Rapids, MI team. You will handle patient eligibility with insurance providers, bill processing, and customer inquiries with a focus on accuracy and timely reporting.

The role emphasizes prior authorizations, payer interactions, and maintaining compliance with HIPAA while supporting daily billing operations in a fast-paced environment.