About the Job
We are seeking a skilled and detail-oriented Pharmacy Billing Specialist responsible for accurate billing, claim submission, and collection of third-party and patient payments for pharmacy products and services. This role plays a critical part in ensuring compliance, maximizing reimbursement, and supporting patients with financial assistance programs.
Key Responsibilities
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Submit timely and accurate invoices for products and services provided.
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Verify services/products are authorized and ensure required documentation is complete.
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Manage Medicare documentation and ensure compliance with medical claims billing.
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Collect patient balances prior to prescription dispensing or in line with company policy.
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Review reports to identify generic substitution opportunities.
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Process reimbursement checks/payments according to company procedures.
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Research and resolve third-party chargebacks and participate in audits as needed.
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Process SDL (submit direct link) claims and review price modification logs.
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Handle prescription exceptions, including prior authorizations and copay assistance.
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Communicate proactively with patients and providers regarding prescription status.
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Assist patients with financial assistance program enrollment and reporting.
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Handle non-clinical phone calls to patients, providers, and third-party payers.
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Serve as a subject matter expert on billing practices, prior authorizations, and financial assistance programs while supporting and coaching staff.
Basic Qualifications
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High School Diploma or equivalent.
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Active Pharmacy Technician license (where required).
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PTCB or ExCPT certification (state certification/registration as applicable).
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Strong communication skills (verbal and written).
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Customer service experience with a focus on quality standards and satisfaction.
Preferred Qualifications
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Six months of retail pharmacy experience (Walgreens preferred).
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Prior medical claims processing experience, including Medicare submissions.
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Knowledge of EOBs (Explanation of Benefits), remittance advice, and filing limits.
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Experience with MS Excel or other database entry systems.
Why Join Us?
Walgreens is proud to be an Equal Opportunity Employer, including disability and veterans. We offer competitive pay, benefits, and growth opportunities. Compensation is based on skills, education, experience, and geography.
👉 Learn more about our benefits: jobs.walgreens.com/benefits
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