Pharmacy Billing Specialist: Detail-Driven & Impactful

Guardian Pharmacy

Orlando (FL)

On-site

USD 22,000 - 28,000

Full time

2 days ago

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Benefits offered by this job

Competitive pay

401(k) with company match

Paid holidays and sick days

Job summary

Guardian Pharmacy of Orlando is seeking a detail-oriented Pharmacy Billing Specialist to join our team onsite in Orlando, Florida. You will handle patient eligibility, billing, and insurance claims, ensuring accuracy and timely processing in a high-volume environment.

Responsibilities include reconciling claims, assisting with open enrollment, maintaining patient records, and ensuring compliance with HIPAA.

Qualifications

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

Responsibilities

Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities.
Maintain and audit patient files and documentation for third party audits and compliance.
Respond to billing inquiries via phone or electronic communications; resolve patient billing issues related to insurance coverage.
Run Medicare plan comparisons during open enrollment and evaluate options to save residents money.
Complete daily census, admit, discharge, and room changes for assigned facilities.
Process patient payments, returns, and credits; transmit credit card payments as needed.
Pursue payment from delinquent accounts and arrange payments.
Research, identify, and organize requested audit documentation timely.
Perform prescription claims adjudication with insurers and rebill as needed.
Develop knowledge of Medicare/Medicaid/PDPs/Third-Party insurances and billing requirements.