Pharmacy Billing Specialist

Overview

A specialized medication management pharmacy is seeking a Pharmacy Billing Specialist responsible for managing patient account payments, submitting insurance claims, and following up on claim statuses. This role supports patient engagement by ensuring accurate billing and payment processing.

Responsibilities

• Prepare and submit clean claims to various insurance companies electronically or by paper
• Respond to inquiries from patients, clerical staff, and insurance companies
• Identify and resolve patient billing complaints
• Prepare, review, and send patient statements
• Evaluate patients' financial status and establish budget payment plans; monitor and report delinquent accounts
• Review accounts for possible assignments and recommend actions to the Billing Supervisor
• Prepare information for collection agencies
• Perform collection activities including contacting patients by phone and correcting/resubmitting claims to third-party payers
• Participate in educational activities and attend monthly staff meetings
• Maintain strict confidentiality and adhere to all HIPAA guidelines and regulations

Requirements

• Minimum 1 year of medical billing and collections experience preferred
• Knowledge of basic medical coding and third-party payer procedures preferred
• Familiarity with business office procedures
• National Certification (PTCB or NHA) required
• Indiana and Pennsylvania State Pharmacy Technician licenses required
• Detail-oriented with strong accuracy
• Proficient in operating computers, software, and basic office equipment
• Skilled in operating multi-line telephone systems and providing courteous phone support
• Ability to read, understand, and follow oral and written instructions
• Ability to establish and maintain effective working relationships with patients, associates, and the public
• Proficiency in reading, writing, and speaking English

Physical Requirements

• Work performed indoors with potential exposure to home office-related safety and health hazards
• May periodically travel to other office and operational sites
• Prolonged periods of sitting and computer use

Compensation & Benefits

• Base hourly wage range: $18.00 to $21.00
• Eligibility for incentive compensation or short-term incentive plans
• Competitive medical, dental, and vision insurance
• Health Savings Account (HSA) and Flexible Spending Account (FSA)
• Voluntary hospital indemnity, critical illness, accident insurance, and short-term disability
• Voluntary life insurance for self, spouse, and dependents
• Company-paid basic life insurance and long-term disability
• Retirement plan with employer match and profit sharing
• Tuition reimbursement program
• Company perks and discount programs
• Wellness and financial education resources
• Employee assistance program

Additional Information

• This position has no direct supervisory responsibilities
• The organization does not sponsor temporary work visas including OPT, H-1B, L-1, O-1, TN, F-1, J-1, E-3, etc.
• Equal opportunity employer; does not discriminate based on age, color, sex, disability, national origin, race, religion, or veteran status