Billing Specialist Pharmacy

Jacksonville, Florida, United States of America

Extraordinary Care. Extraordinary Careers.

With one of the nation’s largest, most innovative long-term care pharmacy services providers, there is no limit to the growth of your career.

Guardian Pharmacy of Jacksonville, a member of the Guardian family of pharmacies, has an exciting opportunity for you to join our rapidly growing team in Jacksonville, Florida.

Why Guardian Pharmacy of Jacksonville? We’re reimagining medication management and transforming care.

Who We Are and What We’re About:

Our core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.

We offer an opportunity to learn and grow your career in a fast-paced, diverse, and inclusive environment. If you are looking for a challenging, team-oriented environment in which you can put your expertise to work, then this is the place for you.

$1000 Sign-on Bonus!*

Schedule: Varying Shifts, Hybrid ; Pharmacy in Jacksonville, FL.

• During training candidate schedule is 9-5:30 until independent enough to switch over to 11:30a-8pm and 6am-2:30pm.  This would likely last about 1-2 months depending on how quickly they learn.

• Position will require 1 weekend shift every 4-5 weeks, rotating. Will work both Saturday and Sunday on their scheduled weekend. Candidate may be asked to cover other varying shifts if a coworker is off on vacation.  

• If located within an hour of the Jacksonville, Florida pharmacy this position would be hybrid and would be required to come to the office 2 day a week.

• Will require a Florida state pharmacy tech license and Frameworks experience is a plus.

This role will be performed at a closed-door pharmacy in Jacksonville, FL.  All patient interactions will be over the phone.

• Comprehensive training provided side by side with training team.
• Must be comfortable working in a high-volume environment.
• We offer full time benefits including health, vision, dental and matching 401k options.

***Must be registered with the Florida Pharmacy Board Registry.

Responsible for processing customer bills and insurance claims in an accurate and timely manner. This includes assisting with all daily and month-end billing functions, procedures and reporting. Provides excellent customer service to patients, caregivers, medical providers and insurance carriers.

ATTRIBUTES REQUIRED:               

• Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
• Relational – ability to build relationships with business unit management and become “trusted advisor.”
• Strategy and Planning – ability to think ahead, plan and manage time efficiently.
• Problem Solving – ability to analyze causes and solve problems at functional level.
• Team Oriented – ability to work effectively and collaboratively with all team members.

ESSENTIAL JOB FUNCTIONS (include the following):

• Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities. Reverify benefit coverage criteria as needed for claims follow up. Accurately enters and/or updates patient/insurance information into billing system.
• Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance.  Accurately enter patient information into the pharmacy system.
• Provide assistance and timely response to all billing customer inquiries via phone or electronic communications. Research and resolve patient billing issues regarding insurance eligibility, coverage, and related benefits.  
• Provide guidance and support to resident or responsible party by running Medicare plan comparisons during open enrollment and special enrollment periods. Proactively review patient profiles, drug regimens and insurance coverage to evaluate options to save resident money.
• Responsible for completion of daily census, admit, discharge, and room changes for the facilities assigned.
• Process patient payments, returns, and credits. Transmit individual credit card payments as needed.
• May pursue payment from delinquent accounts and make paymen