Specialty Pharmacy Billing & Reimbursement Specialist

Walgreens; Durham (NC); On-site; USD 25,000 - 33,000; Full time

Job summary

Walgreens is seeking a Pharmacy Billing Specialist in Durham, NC to manage accurate billing and collection for third party and patient payments. Responsibilities include invoicing payers, ensuring proper documentation, handling prior authorizations, and assisting with audits and patient copay programs.

The role requires a Pharmacy Technician license where required, PTCB/ExCPT certification, and strong communication and customer service skills. Prior Walgreens experience is a plus.

Qualifications

• High School Diploma or equivalent required.
• Pharmacy Technician license in states where required; may require certification.
• PTCB or ExCPT certification through approved program or state registration.
• Experience communicating with various audiences (phone, email, reports).
• Experience providing customer service to internal and external customers.

Responsibilities

• Submit timely invoices to payer for products and services.
• Determine quantities and prices billed accurately.
• Verify authorizations and required documentation.
• Ensure Medicare documentation is received and submitted.
• Review reports to maximize substitution opportunities.
• Manage and collect patient balances prior to dispensing.
• Ensure billing documentation is complete before claim submission.
• Process reimbursement checks per policy.
• Review price modify logs for SDL claims.
• Resolve third party chargebacks promptly.
• Assist with third party audits per policy.
• Process and file SDL claims as required.
• Handle prescription exceptions including prior authorizations and referrals.

Skills

Verbal communication

Written communication

Customer service

Education

High School Diploma or equivalent

Pharmacy Technician license

PTCB or ExCPT certification

Tools

MS Excel

Job description

Walgreens is seeking a Pharmacy Billing Specialist in Durham, NC to manage accurate billing and collection for third party and patient payments. Responsibilities include invoicing payers, ensuring proper documentation, handling prior authorizations, and assisting with audits and patient copay programs.

The role requires a Pharmacy Technician license where required, PTCB/ExCPT certification, and strong communication and customer service skills. Prior Walgreens experience is a plus.