Pharmacy Business Support Specialist

Advocate Health; Winston-Salem (NC); On-site; USD 42,000 - 66,000; Full time

Job summary

Advocate Health in Winston-Salem, NC, seeks a full-time Pharmacy Billing Specialist to join our on-site Finance team. You will reconcile claims, manage receivables, review EOBs, and support Medicare Part B documentation and audits.

The role emphasizes accuracy, attention to detail, and the ability to work with payers, vendors, and pharmacy staff. Experience in pharmacy billing or healthcare accounting is preferred, with proficiency in Excel and standard office software.

Qualifications

• High school diploma or equivalent.
• Typically 2 years’ experience required.
• Pharmacy Technician experience preferred.
• Financial analyst or staff accounting experience preferred.

Responsibilities

• Reconciles pharmacy claims to third party and interdepartmental payments. Tracks and reports payments, receivables, and bad debt.
• Reviews EOBs and reconciles bank deposits.
• Manages documentation and assists in pharmacy financial assistance program processes.
• Utilizes payer and banking portals to research payment denials and exceptions.
• Contacts third party payers to resolve issues resulting in denials/underpayments.
• Responds to payer requests for supporting documentation.
• Communicates payment and remittance information to external billing agencies.
• Submits manual claims as necessary and monitors claim status for proper payment.
• Ensures Medicare Part B documentation is completed and maintained for compliant billing.
• Provides billing compliance training for pharmacy staff.
• Compiles supporting documentation in response to payer audits.
• Manages patient billing and receivables; generates statements and processes payments.
• Administers outpatient pharmacy charity care and extended payment programs.
• Answers pharmacy billing phone line and assists patients with questions.
• Assists with payer credentialing; compiles and submits necessary documentation.
• Submits pharmacy invoices for payment and ensures vendors are paid timely.
• Maintains financial data and generates monthly reports for month-end entries.
• Produces ad hoc management reports as necessary.
• Seeks ways to minimize waste and reduce costs within budget guidelines.

Skills

Mathematical accuracy

Multitasking

Self-motivated

Attention to detail

Team oriented

Education

High school diploma or equivalent

2 years’ experience

Pharmacy Technician experience preferred

Financial analyst or staff accounting experience preferred

Tools

Microsoft Excel

Microsoft Word

Outlook

Adobe Pro

Job description

Position Highlights:

• Full-Time; 40 hours/week, Monday-Friday, 8am-5pm
• Pharmacy Business Operations
• On-site at Piedmont Plaza 1 in Winston Salem

Major Responsibilities:

• Reconciles pharmacy claims to third party and interdepartmental payments. Tracks and reports payments, receivables, and bad debt. Reviews EOB’s and reconciles bank deposits.
• Manage documentation and assist in our pharmacy financial assistance program processes.

• Utilizes payer and banking portals to research payment denials and exceptions. Contacts third party payers to resolve issues resulting in denials/underpayments. Responds to payer requests for supporting documentation.
• Communicates payment and remittance information to external billing agencies.
• Submits manual claims, as necessary. Monitors claim status to ensure proper payment is received.
• Ensures that Medicare Part B documentation is completed and maintained to support compliant billing. Provides billing compliance training for pharmacy staff.
• Compiles relevant supporting documentation in response to payer audits
• Manages patient billing and receivables. Generates patient invoice statements and processes payments. Administers outpatient pharmacy charity care and extended payment programs.
• Answers pharmacy billing phone line and assist patients with questions.
• Assists with payer credentialing. Compiles and submits necessary documentation.
• Submits pharmacy invoices for payment. Ensures pharmacy is invoiced properly and vendors are paid in a timely fashion.
• Maintains financial data and generates monthly reports to support month-end accounting entries.
• Produces ad hoc management reports as necessary.
• Seeks ways to minimize waste and reduce costs. Works within budget guidelines.

Education and Experience:

• High school diploma or equivalent.
• Typically, 2 years’ experience required.
• Pharmacy Technician experience preferred.
• Financial analyst or staff accounting experience preferred.

Licensure, Registration, and/or Certification:

• No certification or license required.
• Registration or licensure with state board of pharmacy, per state of employment requirements preferred.
• Certification through Pharmacy Technician Certification Board (CPhT) or National Healthcareer Association (ExCPT) preferred.

Knowledge, Skills & Abilities Required:

• Proficient with calculator, PC, scanner, and copy machine.
• Proficient with Microsoft Excel, Word, and Outlook.
• Proficient with Adobe Pro.
• Ability to multi-task and be self-motivated.
• Strong mathematical skills and the ability to perform accurate detailed work are a must.
• Ability to work in an environment with interruptions and moderate noise levels.

Physical Requirements and Working Conditions:

• Primarily works within an administrative office environment.
• Requires occasional walking, standing, and lifting up to 25 pounds of material.
• May be required to occasionally stretch, bend, twist, squat, and kneel to perform job.
• Must be able to perform manipulative skills such as writing, typing, and data entry into the computer system.
• Must have use of both hands, be able to see clearly, and read small types such as that on some departmental forms and labels.
• Must be able to speak and be understood by others to communicate effectively.
• Must project a professional image and be team oriented.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive list of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.