Pharmacy Billing Specialist: Medicare & Patient Collections

Walgreens; Placentia (CA); On-site; USD 30,000 - 40,000; Full time

Job summary

Walgreens in Placentia, CA is seeking a Pharmacy Billing Specialist responsible for accurate billing and collection of third-party and patient payments for products and services rendered.

You will submit timely invoices, verify quantities/prices, ensure authorization and documentation, and manage patient balances. A valid Pharmacy Technician license and ongoing certification are required, with experience in Medicare submissions and data entry.

Qualifications

• High School Diploma or equivalent required.
• Pharmacy Technician license in states where required.
• PTCB or ExCPT certification or state certification/registration.

Responsibilities

• Submit timely invoices to payer for products and services provided.
• Determine quantities and prices for billed products/services.
• Verify authorization and required documentation is on file.
• Ensure Medicare documentation is received and submitted.
• Review reports to maximize generic substitution opportunities.
• Manage and collect patient balances prior to dispensing or per policy.
• Ensure billing documentation is complete prior to claim submission.
• Process reimbursement checks/payments per policy.
• Review price modify logs and SDL claims.
• Resolve third party chargebacks promptly.
• Assist with third party audits per policy.
• Process SDL claims per policy.
• Handle prescription exceptions including prior authorizations and referrals.
• Communicate with patients/providers regarding status.
• Assist patients with assistance programs enrollment and eligibility.

Skills

Pharmacy billing

Communication

Attention to detail

Customer service

Education

High School Diploma

Pharmacy Technician license

PTCB/ExCPT certification

Tools

MS Excel

Job description

Walgreens in Placentia, CA is seeking a Pharmacy Billing Specialist responsible for accurate billing and collection of third-party and patient payments for products and services rendered.

You will submit timely invoices, verify quantities/prices, ensure authorization and documentation, and manage patient balances. A valid Pharmacy Technician license and ongoing certification are required, with experience in Medicare submissions and data entry.