Billing Specialist

Required qualifications

• High school diploma or GED
• Pharmacy technician license, certification, or registration per state requirements
• National certification preferred (PTCB), and may be required depending on pharmacy-specific needs
• 1+ years of related experience
• Advanced computer skills; pharmacy information system experience preferred
• Strong attention to detail and accuracy
• Ability to work independently and meet deadlines
• Ability to manage multiple tasks in a fast-paced, team-oriented environment
• Quality-minded with a focus on identifying and correcting errors

Key job functions

• Research and verify patient eligibility and insurance coverage
• Update patient and insurance information in billing and pharmacy systems
• Maintain and audit patient files and documentation for compliance and audit readiness
• Respond to billing inquiries from patients, caregivers, providers, and insurers
• Help with Medicare plan comparisons during open and special enrollment periods
• Process daily census, admit, discharge, and room changes for assigned facilities
• Process patient payments, returns, and credits
• Support collections and payment arrangements for delinquent accounts
• Research and organize audit documentation
• Adjudicate prescription claims, resolve rejections, support prior authorizations, and rebill claims as needed
• Learn and apply pharmacy billing requirements for Medicare, Medicaid, PDPs, and third-party insurance
• Use pharmacy information systems to support billing, reporting, and regulatory compliance
• Follow HIPAA and other applicable government regulations

Compensation & financial

• Competitive pay
• 401(k) with company match

Family, health & insurance benefits

• Medical, dental, and vision coverage
• Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA)
• Company-paid basic life and accidental death & dismemberment insurance
• Company-paid long-term disability insurance
• Optional short-term disability coverage
• Voluntary employee and dependent life, accident, and critical illness coverage
• Dependent care flexible spending accounts

Wellbeing

• Employee Assistance Program (EAP)
• Guardian Angels employee assistance fund

Time off

• Paid holidays and sick days
• Generous vacation benefits based on years of service