Specialty Pharmacy Billing Specialist

Walgreens; Huntersville (NC); On-site; USD 30,000 - 40,000; Full time

Job summary

Walgreens is seeking a Pharmacy Billing Specialist to manage invoicing and claim submission for products and services across payer networks. You will verify authorizations, ensure documentation, and support patient billing while coordinating with providers and pharmacies.

Key responsibilities include handling prior authorizations, auditing SDL claims, and assisting with third party audits while maintaining strong knowledge of Medicare processes and patient assistance programs.

Qualifications

• High School Diploma or equivalent required.
• Pharmacy Technician license in states where required and active certification/registration.
• Experience communicating verbally and in writing to diverse audiences.

Responsibilities

• Submit timely, accurate invoices to payer for products and services.
• Determine quantities and prices billed.
• Verify authorization and required documentation on file.
• Ensure Medicare documentation is received and submitted.
• Review reports to maximize generic substitution opportunities.
• Manage and collect patient balances prior to dispensing.
• Ensure billing documentation is complete before 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 as per policy.
• Process and file SDL claims as required.
• Handle prior authorizations and referrals triage to other Walgreens locations.
• Communicate with patients and providers about status of referrals/ prescriptions.
• Assist patients with assistance programs enrollment and eligibility reporting.
• Handle non-technical calls to physicians and payers.

Skills

Pharmacy license

Communication skills

Customer service

Data entry

Medicare knowledge

Education

High School Diploma or equivalent

PTCB/ExCPT certification

Tools

MS Excel

Billing systems

Job description

Walgreens is seeking a Pharmacy Billing Specialist to manage invoicing and claim submission for products and services across payer networks. You will verify authorizations, ensure documentation, and support patient billing while coordinating with providers and pharmacies.

Key responsibilities include handling prior authorizations, auditing SDL claims, and assisting with third party audits while maintaining strong knowledge of Medicare processes and patient assistance programs.