Senior Pharmacy Billing Specialist: Medicare & Medicaid Claims

Guardian Pharmacy; Phoenix (AZ); On-site; USD 29,000 - 33,000; Full time

Benefits offered by this job

Health plans

Dental and Vision plans

Life insurance

401(k) with company match

EAP

Job summary

Saliba’s Extended Care Pharmacy, part of the Guardian family, in Phoenix, AZ, seeks a detail-oriented pharmacy billing specialist to process bills and insurance claims with accuracy and speed.

You will support daily and month-end billing, interact with patients, caregivers, providers, and insurers, and help ensure compliant, efficient billing operations in a fast-paced healthcare setting.

Qualifications

• Minimum 2+ years related experience including at least 6 months billing in long term care or retail.
• Advanced computer skills; proficiency with pharmacy information systems.
• Ability to work independently, meet deadlines, and maintain accuracy.

Responsibilities

• Research and establish patient eligibility coverage with insurance providers; enter data into billing system.
• Maintain and audit patient files; defend third party audits and ensure payer compliance.
• Respond to billing inquiries via phone or electronic communications; resolve issues.
• Run Medicare plan comparisons during enrollment periods and evaluate coverage to save residents money.
• Process daily census, admissions, discharges, and room changes for facilities.
• Process payments, credits, and transmit credit card payments as needed.
• Pursue delinquent payments and arrange payment plans as necessary.
• Handle claims adjudication, rejections, and prior authorizations with insurance providers.

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

Billing software

Job description

Saliba’s Extended Care Pharmacy, part of the Guardian family, in Phoenix, AZ, seeks a detail-oriented pharmacy billing specialist to process bills and insurance claims with accuracy and speed.

You will support daily and month-end billing, interact with patients, caregivers, providers, and insurers, and help ensure compliant, efficient billing operations in a fast-paced healthcare setting.