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Billing Specialist

3 months ago

Marietta, Georgia, United States Guardian Pharmacy Full time

Marietta, Georgia, United States of America

Guardian Pharmacy of Atlanta is part of the Guardian Pharmacy Services network and prides itself on its emphasis on customer service. Each team member plays a vital role in the success of the pharmacy.

Description:

  • Schedule: Monday-Friday 10:30am-7pm. Flexibility to work Saturdays 9am-3pm when required.
  • This position will be based at a closed-door pharmacy in Marietta, GA
We Provide:
  • Comprehensive training alongside our dedicated training team.
  • Full benefits package including: Medical, Dental, Vision, Life Insurance, and a matching 401K option.
  • Competitive hourly compensation.
Responsible for accurately and promptly handling customer billing and insurance claims. This involves assisting with daily and monthly billing procedures, processes, and reporting. Ensuring exceptional customer service for patients, caregivers, medical providers, and insurance companies.

REQUIRED QUALITIES:
  • Work Ethic/Integrity - demonstrating a drive for excellence aligned with company values
  • Relational - building strong relationships with business unit management to be a trusted advisor.
  • Strategy and Planning - forward-thinking, efficient time management skills.
  • Problem Solving - analyzing causes and resolving issues effectively.
  • Team Oriented - collaborating effectively with all team members.
KEY RESPONSIBILITIES (include but not limited to):
  • Verify patient insurance coverage with providers, private or government entities. Update patient/insurance information accurately in the billing system.
  • Maintain and audit patient files for third party audits and compliance. Enter patient information correctly into the pharmacy system.
  • Address billing inquiries promptly via phone or electronic channels. Resolve billing issues related to insurance coverage and eligibility.
  • Assist residents with Medicare plan comparisons during enrollment periods. Review patient profiles and insurance coverage to suggest cost-saving options.
  • Complete daily census, admissions, discharges, and room changes for assigned facilities.
  • Process patient payments, returns, and credits. Follow up on delinquent accounts and arrange payments.
  • Organize audit documentation accurately and in a timely manner.
  • Handle prescription claims adjudication, communicate with insurance companies for claim issues.
  • Understand pharmacy billing requirements for Medicare, Medicaid, and Third-Party Insurances.
  • Utilize pharmacy information systems for operational and billing functions.
  • Gain knowledge of other department workflows by rotating through different departments.
  • Adhere to all government regulations including HIPAA.
  • Collaborate with the team to meet pharmacy service goals.
  • Other duties may be assigned as required.
EDUCATION AND/OR CERTIFICATIONS:
  • High School Diploma or GED required.
  • Pharmacy Technician license/registration per state requirements; National Certification preferred (PTCB) may be necessary.
SKILLS AND QUALIFICATIONS:
  • 1+ years of relevant experience
  • Proficiency in computer skills; experience with pharmacy information systems preferred.
  • Ability to work independently and meet deadlines.
  • Attention to detail and accuracy essential.
  • Comfortable in a fast-paced, team environment managing multiple tasks.
  • Quality-oriented individual with a focus on error detection.
WORK ENVIRONMENT: Characteristics of the work environment an employee may expect:
  • Low to moderate noise level.
  • Interaction with others in an office setting, managing conflicts, deadlines.
  • Desk work in office environment.
  • Flexibility in working hours.
Full-Time employees with 30+ hours per week qualify for our benefits package including medical, dental, vision, disability, life insurance, and PTO.

All team members can participate in our matched 401(k) plan.