Medical Billing Specialist jobs in Wilmington, NC

Southern Pharmacy Services is part of the Guardian Pharmacy Services network and prides itself on its customer service. Each team member plays an integral part in the success of the pharmacy.

Regional Billing Specialist

Works directly with the Regional Billing Lead and Regional Billing Manager to execute various billing tasks for each of the pharmacy locations.  Assisting in audit compliance, vaccine billing, Medicare open enrollment, ancillary billing charges, cost comparisons and other billing-related tasks.

Attributes Required:               

• Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
• Strategy and Planning – ability to think ahead, plan and manage time efficiently
• Problem Solving – ability to analyze causes and solve problems at both a strategic and functional level with minimal direction
• Team Oriented – ability to work effectively and collaboratively with all team members
• Detail Oriented – ability to provide attention to detail
• Organizational – ability to organize work around multiple priorities and deadlines

Essential Job Functions (include the following):

• Assist in researching, identifying and organizing documentation related to the timely processing of PBM audit requests for all SPS locations
• Assist in monitoring and executing all billing-related functions surrounding vaccine clinics
• Create ancillary revenue billing transactions according to contract and pharmacy performance at required intervals (monthly, quarterly, etc..)
• Participate in special enrollment and open enrollment activities as needed
• Perform new admission medication cost reviews as needed
• Provide customer service to internal and external customers as needed
• Update and process low income subsidies as needed
• Any other responsibilities as directed by supervisor

Education and/or Certifications:

• High School diploma required, college degree in business preferred
• Pharmacy Technician registration required; National Certification preferred (PTCB)

Skills and Qualifications:

• Excellent computer skills, including MS Office (Excel, Word, Teams)
• Excellent verbal and written communication skills; professional demeanor
• Strong attention to detail and analysis skills
• Ability to maintain confidentiality at all levels
• Ability to work to deadlines and balance multiple priorities
• Strong work ethic and desire to excel
• Pharmacy experience required
• Collections and Adjudication experience preferred
• FrameworkLTC and FrameworkECM experience required
• Strong knowledge of 3rd party insurance requirements
• Strong knowledge of pharmacy documentation requirements preferred

Work Environment:

• Ability to work flexible hours

Full-Time employees working 30 hours per week are eligible to enroll in our comprehensive benefits package, which includes medical, dental, vision, short and long-term disability, life and supplemental life insurance, and PTO.

All employees are eligible to enroll in our company matched 401(k) plan.

About the Company:
Guardian Pharmacy, LLC