Medical Billing Specialist

1 week ago


Atlanta, Georgia, United States Walgreens Full time
Job Summary

We are seeking a highly skilled Medical Billing Specialist to join our team at Walgreens. As a key member of our revenue cycle team, you will be responsible for accurately billing and collecting payments from third-party payers and patients.

Key Responsibilities
  • Submit timely and accurate invoices to payers for products and services provided.
  • Determine quantities and prices for products and services billed with precision.
  • Verify services and products are correctly authorized and required documentation is on file.
  • Ensure all Medicare documentation is received from the medical provider and submitted to Danville.
  • Maximize generic substitution opportunities by reviewing reports.
  • Collect patient balances prior to prescription dispensing or in accordance with company policy.
  • Complete and ensure accuracy of required documentation for billing before claim submission.
  • Process reimbursement checks/payment according to policy.
  • Review price modify logs and ensure corresponding SDL claims.
  • Resolve third-party chargebacks in a timely manner.
  • Assist with third-party audits as per company policy.
  • Process and file SDL claims according to company policy.
  • Process prescription exceptions including prior authorizations and referrals.
  • Communicate proactively with patients and providers regarding referral/prescription status.
  • Maintain expertise on external billing practices and coach pharmacy technicians/staff.
Requirements
  • High School Diploma or equivalent.
  • Pharmacy Technician license (where required).
  • PTCB or ExCPT certification through designated program/state requirements.
  • Effective communication skills (verbal/written) for various audiences.
  • Customer service experience meeting quality standards.
Preferred Qualifications
  • Six months of retail experience.
  • Prior work experience with Walgreens.
  • Experience with medical claims submission (Medicare/EOB/Remittance advice).
  • Data entry experience (MS Excel).
About the Role

This role offers an estimated salary range of $45,000 - $65,000 annually, depending on location and experience.

We offer a comprehensive benefits package, including health insurance, retirement plan, and paid time off.



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