Pharmacy Billing Specialist – Claims & Insurance

Guardian Pharmacy Services Management, LLC; Grand Rapids (MI); On-site; USD 28,000 - 33,000; Full time

Benefits offered by this job

Medical, Dental and Vision

401(k) with company match

Paid holidays and vacation

Job summary

Guardian Pharmacy of Michigan in Grand Rapids, Michigan is seeking a Billing Specialist to process patient bills and insurance claims, manage daily and month-end billing tasks, and deliver exceptional service to patients, caregivers, medical providers, and payers. This on-site role supports Medicare, Medicaid, PDPs and third-party plans.

Candidates should have 1+ year of related experience, a high school diploma or GED, and pharmacy information system familiarity.

Qualifications

• 1+ years of related experience
• High attention to detail and accuracy
• Ability to work independently and meet deadlines
• Experience with billing and insurance processes is a plus

Responsibilities

• Research and establish patient eligibility with insurers, update billing information
• Maintain and audit patient files and ensure payer compliance
• Respond to billing inquiries via phone or electronic communications
• Run Medicare plan comparisons during enrollment periods and review patient profiles
• Process daily census, admissions, discharges, and room changes
• Process payments, refunds, and credits; transmit card payments
• Resolve delinquent accounts and arrange payments as needed
• Handle audits documentation and pharmacy billing requirements
• Utilize pharmacy information systems for PAs, rejections, reports, and billing

Skills

Work Ethic/Integrity

Relational

Strategy and Planning

Problem Solving

Team Oriented

Education

High School Diploma or GED

Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB)

Tools

Pharmacy information system

Advanced computer skills

Job description

Guardian Pharmacy of Michigan in Grand Rapids, Michigan is seeking a Billing Specialist to process patient bills and insurance claims, manage daily and month-end billing tasks, and deliver exceptional service to patients, caregivers, medical providers, and payers. This on-site role supports Medicare, Medicaid, PDPs and third-party plans.

Candidates should have 1+ year of related experience, a high school diploma or GED, and pharmacy information system familiarity.