Pharmacy Billing Specialist – Long-Term Care

Guardian Pharmacy; Englewood (CO); On-site; USD 32,000 - 36,000; Full time

Benefits offered by this job

Medical, Dental and Vision

401(k) with company match

Paid holidays and sick days

Generous vacation benefits

EAP

Job summary

Guardian Pharmacy of Englewood, CO is seeking a Pharmacy Billing Specialist to process patient bills and insurance claims with accuracy. You will conduct daily, month-end billing, respond to inquiries, and support Medicare/Medicaid and third-party processes.

Required: 2+ years billing-related experience in LTC or retail, and proficiency with pharmacy software. Great attention to detail and the ability to work independently are essential.

Qualifications

• 2+ years related experience including a minimum of 6 months billing experience in long term care or retail setting.
• Advanced computer skills; pharmacy information system experience required.
• Ability to work independently and deliver to deadlines.
• Great attention to detail and accuracy
• Ability to excel in a fast-paced, team-oriented environment working on multiple tasks
• Quality minded; motivated to seek out errors and inquire about inaccuracies.

Responsibilities

• Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities.
• Maintain and audit patient files and documentation to defend third party audits.
• Provide assistance and timely response to all billing inquiries via phone or electronic communications.
• Run Medicare plan comparisons during open enrollment and special enrollment periods.
• Complete daily census, admit, discharge, and room changes for facilities assigned.
• Process patient payments, returns, and credits; transmit card payments.
• Research, identify, and organize requested audit documentation timely.
• Perform prescription claims adjudication and resolve rejections with insurers.
• Utilize pharmacy information systems to meet regulatory requirements and billing functions.
• Meet pharmacy’s established accuracy and productivity levels.
• Follow HIPAA and work collaboratively with the team.

Job description

Guardian Pharmacy of Englewood, CO is seeking a Pharmacy Billing Specialist to process patient bills and insurance claims with accuracy. You will conduct daily, month-end billing, respond to inquiries, and support Medicare/Medicaid and third-party processes.

Required: 2+ years billing-related experience in LTC or retail, and proficiency with pharmacy software. Great attention to detail and the ability to work independently are essential.