Specialty Pharmacy Billing Specialist

Walgreens; New Brunswick (NJ); On-site; USD 30,000 - 40,000; Full time

Job summary

Walgreens Co. in New Jersey seeks a Pharmacy Billing Specialist to handle accurate third-party and patient payments for products and services. You will submit invoices, verify authorizations, review Medicare docs, and support collection efforts while maintaining policy compliance.

The role emphasizes clear communication with providers and patients and requires meticulous data entry. Experience with medical claims, Excel data entry, EOBs, and remittance advice is preferred.

Qualifications

• Experience submitting medical claims and payer invoicing.
• Clear communication with patients, providers and payers.
• Knowledge of Medicare documentation and timely filing limits.
• Strong data entry and attention to detail.
• Experience with patient financial assistance programs is a plus.

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 and submitted as required.
• Review reports to maximize generic substitution opportunities.
• Manage and collect patient balances prior to prescription dispensing, or per policy.
• Ensure all billing documentation is completed and accurate prior to claim submission.
• Process reimbursement checks/payments in accordance with policy.
• Review price modify logs and ensure SDL claims are filed.
• Review, research and resolve third party chargebacks promptly.
• Assist with third party audits per policy.
• File all SDL claims per policy.
• Process prescription exceptions including prior authorizations and referrals.
• Communicate proactively with patients/providers regarding referral/prescription status.
• Assist patients with enrollment in assistance programs and verify eligibility.
• Handle calls that do not require pharmacist attention and coordinate with payers.
• Maintain expertise on external billing practices to coach staff.

Skills

Billing and collections

Communication skills

Customer service

Pharmacy terminology

Prior authorization

Data entry

Attention to detail

Education

High School Diploma or equivalent

Pharmacy Technician license

PTCB or ExCPT certification

Tools

MS Excel

Billing systems

Job description

Walgreens Co. in New Jersey seeks a Pharmacy Billing Specialist to handle accurate third-party and patient payments for products and services. You will submit invoices, verify authorizations, review Medicare docs, and support collection efforts while maintaining policy compliance.

The role emphasizes clear communication with providers and patients and requires meticulous data entry. Experience with medical claims, Excel data entry, EOBs, and remittance advice is preferred.