Specialty Billing Specialist

4 weeks ago


New Brunswick, New Jersey, United States Walgreens Full time
Job Description:

As a Specialty Billing Technician at Walgreens, you will play a crucial role in ensuring the accurate billing and collection of third-party and patient payments for products and services rendered. Your attention to detail and organizational skills will be essential in managing and collecting patient balances prior to prescription dispensing, as well as ensuring all required documentation for billing is completed and accurate prior to claim submission.

Key Responsibilities:

  • Submit timely and accurate invoices to payers for products and services provided.
  • Correctly determine quantities and prices for products and services billed.
  • 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.
  • Review reports to maximize generic substitution opportunities.
  • Manage and collect patient balances prior to prescription dispensing, or in accordance with company policy.
  • Ensure all required documentation for billing is completed and accurate prior to claim submission.
  • Process reimbursement checks/payment in accordance with policy.
  • Review price modify logs and ensure there are corresponding SDL (submit direct link) claims.
  • Review, research, and resolve all third-party chargebacks in a timely manner.
  • Assist with any third-party audits, in accordance with company policy.
  • Process and file all SDL (submit direct link) claims in accordance with company policy.

Additional Responsibilities:

  • Process prescription exceptions, including prior authorizations, triaging of referrals to other Walgreens locations, and proactively identifying copay assistance opportunities.
  • Proactively communicate with patients and providers regarding referral/prescription status.
  • Maintain a deep understanding of and assist patients with assistance programs enrollment, such as Chronic Disease Fund, confirming patient eligibility and all required reporting and documentation.
  • Handle telephone calls that do not require personal attention of the pharmacist, including those to physicians and third-party payers.
  • Maintain subject matter expertise pertaining to all external billing practices, including but not limited to third-party adjudications, prior authorization, and patient financial assistance programs, in order to coach pharmacy technicians and other support staff.

Requirements:

  • High School Diploma or equivalent.
  • Pharmacy Technician license, in states where required.
  • Maintains PTCB or ExCPT certification through the designated PTCB or ExCPT training program and/or state required certification/registration.
  • Experience communicating both verbally (on phone, one-on-one, to groups) and in writing (emails, letters, reports, presentations) to various audiences (work group, team, company management, prospective acquisitions, external clients).
  • Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.

Preferred Qualifications:

  • Prefer six months of experience in a retail environment.
  • Prefer to have prior work experience with Walgreens.
  • Experience in processes related to submitting medical claims, including but not limited to Medicare submission, knowledgeable in EOB (explanation of benefits), remittance advice, and adherence to timely filing limits.
  • Experience entering data into databases (e.g., MS Excel).

Equal Opportunity Employer:

Walgreens is an Equal Opportunity Employer, including disability/veterans.

Actual Compensation:

The actual compensation that you will be offered will depend on a variety of factors, including geography, skills, and abilities, education, experience, and other relevant factors.



  • New Brunswick, New Jersey, United States Walgreens Full time

    Job Title: Specialty Billing TechnicianJob Summary:As a Specialty Billing Technician at Walgreens, you will play a critical role in ensuring the accurate and timely billing and collection of third-party and patient payments for products and services rendered. This position requires strong communication and organizational skills, as well as the ability to...


  • New York, New York, United States RC Billing Full time

    Job Summary:As an EDI Billing Specialist at RC Billing, you will be responsible for ensuring timely and accurate claim submissions, file maintenance, and data integrity. This role requires strong organizational and communication skills, as you will work closely with various departments to resolve issues and ensure client satisfaction.Key...


  • New York, New York, United States Billing Geeks Full time

    We are seeking a dedicated and detail-oriented Medical Biller/Collections Specialist to join our team at Billing Geeks. The ideal candidate will have a strong understanding of medical billing and collections, with experience working with EHR workflows, claim submission, payment posting, and A/R reporting.Key Responsibilities:Verify patient insurance coverage...

  • EDI Claims Specialist

    1 month ago


    New York, New York, United States RC Billing Full time

    Job SummaryWe are seeking a highly skilled EDI Billing Specialist to join our team at RC Billing. The successful candidate will be responsible for timely daily claim submissions and file maintenance functions in accordance with our billing standards and reimbursement policy and procedures.Key ResponsibilitiesTimely completion of daily claim submissions and...


  • New Providence, New Jersey, United States PRISM Vision Group Full time

    Job SummaryThe Revenue Cycle Specialist is a key member of the PRISM Vision Group team, responsible for managing the financial aspects of our ophthalmology practice. This role involves a variety of duties, including accounts receivable, billing, and insurance claims. The ideal candidate will have a strong understanding of medical billing procedures,...


  • New York, New York, United States Altus Pediatric Billing Full time

    Work from Home with FlexibilityAt Altus Pediatric Billing, we're committed to hiring the best pediatric billers who understand the importance of delivering exceptional client service. We know that life can be unpredictable, which is why we offer a flexible schedule that allows our team members to set their own hours.Whether you're a morning person or a night...

  • Billing Specialist

    4 weeks ago


    New York, New York, United States AHRC NYC Full time

    Billing Specialist Job DescriptionAHRC New York City is seeking a skilled Billing Specialist to join their team. As a key member of the Residential Division, this role will be responsible for maintaining accurate records and ensuring compliance with regulatory rules.Collect and review daily billing paperwork to ensure accuracy and timeliness.Collaborate with...

  • Billing Specialist

    1 month ago


    New York, New York, United States WalkMe Full time

    Job Title: Billing SpecialistWalkMe is seeking a highly skilled Billing Specialist to join our team. As a key member of our finance department, you will be responsible for providing financial and administrative services to support our hyper-growth.Key Responsibilities:Manage billing tasks, including producing invoices and credit memos in accordance with...


  • New York, New York, United States CAIPA MSO Full time

    Job SummaryThe Medical Billing Specialist will be responsible for managing the billing process, including charge entry, edits, payment posting, and accounts receivable. The ideal candidate will have a strong understanding of medical billing procedures and be proficient in computerized medical billing systems.Key Responsibilities• Verify insurance and...

  • Billing Specialist

    1 month ago


    New Rochelle, New York, United States Northeast Family Services Full time

    Job Title: Billing SpecialistAt Northeast Family Services, we are seeking a highly skilled Billing Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely billing and claims submissions.Key Responsibilities:Prepare and submit clean and accurate claims to payersMonitor and resolve...


  • New York, New York, United States Ambassador Resources Full time

    Medical Billing SpecialistAt Ambassador Resources, we are seeking a skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will play a crucial role in our mission to provide exceptional care to children on the autism spectrum.Key Responsibilities:• Perform billing and invoicing tasks twice a week• Submit billing data to...

  • Billing Specialist

    4 weeks ago


    New York, New York, United States Consultative Search Group Full time

    Consultative Search Group is seeking a skilled Billing Specialist to join its team in a remote capacity. The ideal candidate will have experience in complex billing arrangements, including multi-payor, volume discounts, and alternative fee arrangements.Key Responsibilities:Collaborate with the Pricing department to finalize and implement billing...


  • New York, New York, United States Mount Sinai Health System Full time

    The Senior Oncology Billing Specialist is responsible for multiple components of the billing process, including Accounts Receivable, Charge Entry, Edits, and Payment Posting.This role demonstrates proficiency in these processes to facilitate accurate and timely payment of claims and collection, and is considered a subject matter expert for those less...


  • New York, New York, United States AMS Staffing, Inc. Full time

    Job OpportunityWe are seeking a highly skilled Billing and Compliance Specialist to join our team at AMS Staffing, Inc.Job SummaryThe Billing and Compliance Specialist will be responsible for preparing bills in accordance with client guidelines and partner instructions. They will review time and disbursement records and address compliance issues, collaborate...


  • New York, New York, United States destinationone Consulting Full time

    Job Title: Medical Billing SpecialistDestinationone Consulting is seeking a highly skilled Medical Billing Specialist to join our team. As a key member of our healthcare recruitment team, you will be responsible for managing the billing process for our clients, ensuring accurate and timely submission of claims and payments.Key Responsibilities:Prepare and...


  • New York, New York, United States Destinationone Consulting Full time

    Medical Billing Specialist Job DescriptionDestinationone Consulting is a leading recruitment agency specializing in diverse sectors, including Healthcare, Health Tech, Government, Municipalities, Non-Profits, Legal, Public Accounting, and more.We are proactively building a database of opportunities in these fields. By applying, you ensure our recruiters can...


  • New York, New York, United States Billing Geeks Full time

    About Billing GeeksBilling Geeks is a leading medical billing company dedicated to providing efficient and accurate billing solutions to healthcare providers. Our mission is to streamline the revenue cycle process, ensuring maximum reimbursement and exceptional service for our clients.Job DescriptionWe are seeking a highly organized and proactive Executive...


  • New York, New York, United States MAP SSG Full time

    Job Title: Senior Client Billing SpecialistJob Summary:The Senior Client Billing Specialist will be responsible for preparing bills in accordance with client guidelines and partner instructions. They will review time and disbursement records and address compliance issues, collaborate with attorneys, clients and colleagues, and address requests and special...


  • New York, New York, United States Mount Sinai Health System Full time

    Job SummaryAs a Medical Billing Specialist at Mount Sinai Health System, you will play a critical role in ensuring the accuracy and efficiency of our billing processes. This position requires a high level of attention to detail and the ability to work in a fast-paced environment.Key ResponsibilitiesPost charges for services and review encounter forms for...


  • New Brunswick, New Jersey, United States Specialty Professional Services Full time

    Cath Lab Technologist OpportunityWe are seeking a skilled Cath Lab Technologist to join our team at Specialty Professional Services. The ideal candidate will possess a current NJ license or Compact license, depending on the state. A minimum of 1 year of recent experience in Cath Lab is required.Key Responsibilities:Work a 3x12 Days shift in New Brunswick,...