Pharmacy Billing Specialist

4 hours ago

Madison, Wisconsin, United States Guardian Pharmacy Full time
Job Title: Pharmacy Billing Specialist

Guardian Pharmacy of Wisconsin is seeking a highly skilled Pharmacy Billing Specialist to join our team in Madison, Wisconsin. As a key member of our team, you will be responsible for processing customer bills and insurance claims in an accurate and timely manner.

Key Responsibilities:
  • Research and establish patient eligibility coverage with insurance providers, including private individuals and/or government entities.
  • Maintain and continually audit patient files and corresponding documentation necessary to defend third-party audits and ensure payer and company compliance.
  • Provide assistance and timely response to all billing customer inquiries via phone or electronic communications.
  • Process patient payments, returns, and credits, and transmit individual credit card payments as needed.
  • May pursue payment from delinquent accounts and make payment arrangements.
  • Research, identify, and organize requested audit documentation in a timely manner.
  • Perform prescription claims adjudication, including communication with insurance companies regarding rejected claims, eligibility, prior authorizations, or other issues as needed.
Requirements:
  • High School Diploma or GED required.
  • Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required (pharmacy specific).
  • 1+ years of related experience.
  • Advanced computer skills; pharmacy information system experience preferred.
  • Ability to work independently and deliver to deadlines.
  • Great attention to detail and accuracy.
  • Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines.
What We Offer:
  • Competitive pay.
  • 401(k) with up to 3.5% company match.
  • Multiple health plan options, including copay (FSA-eligible) and HSA-eligible plans.
  • Wellness Incentive Program.
  • Dental and Vision plans.
  • Company-paid basic life, AD&D, and long-term disability coverage.
  • Optional employee, spouse, and child life/AD&D insurance.
  • Optional accident, critical illness, and short-term disability coverage.
  • Dependent Care Flexible Spending Accounts.
  • Employee Assistance Program (EAP).

Guardian Pharmacy of Wisconsin is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to fostering a diverse and inclusive workforce.

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