Specialty Pharmacy Billing & Claims Specialist

Walgreens; Rockford (IL); On-site; USD 28,000 - 36,000; Full time

Job summary

Walgreens is seeking a Billing Specialist to manage accurate invoicing and collections for products and services rendered. You will submit invoices, verify authorizations, and ensure supporting documentation meets payer requirements.

Responsibilities include Medicare submissions, patient balance recovery, SDL/claims processing, and assisting with audits while coaching staff on billing best practices. This role emphasizes customer service and compliance in a fast-paced environment.

Qualifications

• High School Diploma or equivalent.
• Pharmacy Technician license where required.
• PTCB or ExCPT certification maintained.
• Experience communicating verbally and in writing to various audiences.
• Experience providing customer service to internal and external customers.

Responsibilities

• Submit timely, accurate invoices to payer for products and services provided.
• Correctly determine quantities and prices for products and services billed.
• Verify services and products are correctly authorized and required documentation is on file.
• Ensure Medicare documentation is received from the medical provider and submitted.
• Review reports to maximize generic substitution opportunities.
• Manage and collect patient balances prior to prescription dispensing, or per policy.
• Ensure all billing documentation is complete and accurate prior to claim submission.
• Process reimbursement checks/payments in accordance with policy.
• Review price modify logs and SDL claims.
• Review, research and resolve all third party chargebacks promptly.
• Assist with third party audits per policy.
• Process and file all SDL claims per policy.
• Process prescription exceptions including prior authorizations and referrals.
• Communicate with patients/providers regarding referral/prescription status.
• Assist patients with assistance programs enrollment and eligibility.
• Handle calls not requiring pharmacist attention, including to physicians and payers.
• Maintain expertise in external billing practices to coach staff.

Skills

Communication

Customer service

Education

High School Diploma

Pharmacy Technician license

PTCB or ExCPT certification

Tools

MS Excel

Job description

Walgreens is seeking a Billing Specialist to manage accurate invoicing and collections for products and services rendered. You will submit invoices, verify authorizations, and ensure supporting documentation meets payer requirements.

Responsibilities include Medicare submissions, patient balance recovery, SDL/claims processing, and assisting with audits while coaching staff on billing best practices. This role emphasizes customer service and compliance in a fast-paced environment.