Pharmacy Billing Specialist - Claims & Eligibility Expert

Guardian Pharmacy; Boca Raton (FL); On-site; USD 34,000 - 56,000; Full time

Benefits offered by this job

Medical, Dental and Vision

401(k) with company match

Paid holidays and sick days

Generous vacation

Job summary

Guardian Pharmacy Southeast Florida is seeking a billing-focused pharmacy support specialist to process patient bills and insurance claims onsite in Boca Raton, FL. All patient interactions are over the phone, with comprehensive training provided.

The role requires 1+ year in a related field, strong attention to detail, and proficiency with pharmacy information systems. Full-time benefits include health, vision, dental, and 401k matching.

Qualifications

• 1+ years of related experience in a pharmacy billing or similar role.
• Pharmacy information systems experience preferred.
• Ability to work independently and meet deadlines.
• Great attention to detail and accuracy in processing billing and claims.

Responsibilities

• Research and establish patient eligibility coverage with insurance providers.
• Enter and update patient/insurance information in billing system; maintain files.
• Respond to billing inquiries and resolve issues related to eligibility and benefits.
• Run Medicare plan comparisons during open enrollment and evaluate options to save costs.
• Manage daily census, admissions, discharges, and room changes for facilities.
• Process patient payments, returns, and credits; transmit credit card payments.
• Pursue payment from delinquent accounts and arrange payments when needed.
• Perform insurance claims adjudication, handle rejections, and rebill when necessary.
• Develop knowledge of Medicare, Medicaid, PDPs, and third-party insurances for billing.

Skills

Experience

Attention to detail

Independent work

Fast-paced environment

Pharmacy software

Education

High School Diploma

Pharmacy technician certification

Tools

Pharmacy information system

Job description

Guardian Pharmacy Southeast Florida is seeking a billing-focused pharmacy support specialist to process patient bills and insurance claims onsite in Boca Raton, FL. All patient interactions are over the phone, with comprehensive training provided.

The role requires 1+ year in a related field, strong attention to detail, and proficiency with pharmacy information systems. Full-time benefits include health, vision, dental, and 401k matching.