Specialty Pharmacy Billing Specialist

Walgreens

New Brunswick (NJ)

On-site

USD 30,000 - 40,000

Full time

14 days+

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Job summary

Walgreens is seeking a Billing & Claims Specialist to manage third‑party and patient payments for products and services. You will ensure accurate invoicing, proper authorizations, and timely Medicare submissions while supporting patients with financial assistance programs.

The role emphasizes strong communication, attention to detail, and familiarity with MS Excel for data entry and reporting. Prior Walgreens experience is preferred; full‑time on-site position in New Jersey.

Qualifications

High School Diploma or equivalent.
Pharmacy Technician license, in states where required.
Maintains PTCB or ExCPT certification through the designated program and/or state required certification/registration.
Experience communicating both 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 to Danville.
Review reports to maximize generic substitution opportunities.
Manage and collect patient balances prior to prescription dispensing, or per company policy.
Ensure all billing documentation is complete and accurate prior to claim submission.
Process reimbursement checks/payment in accordance with policy.
Review price modify logs and ensure SDL claims correspond.
Review, research and resolve all third party chargebacks promptly.
Assist with third party audits according to policy.
Process and file all SDL claims as required.
Process prescription exceptions including prior authorizations and referrals; identify copay assistance opportunities.
Communicate proactively with patients and providers regarding referral/prescription status.
Assist patients with enrollment in assistance programs and verify eligibility and reporting requirements.
Handle telephone calls not requiring pharmacist attention, including calls to physicians and payers.
Maintain expertise on external billing practices to coach staff.