Medical Billing Specialist
1 week ago
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.
- 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.
- Six months of retail experience.
- Prior work experience with Walgreens.
- Experience with medical claims submission (Medicare/EOB/Remittance advice).
- Data entry experience (MS Excel).
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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