Senior Pharmacy Technician – Billing Specialist jobs in United States
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Guardian Pharmacy · 3 weeks ago

Senior Pharmacy Technician – Billing Specialist

Guardian Pharmacy is one of the nation’s largest, most innovative long-term care pharmacy services providers, offering an exciting opportunity for career growth. The Senior Pharmacy Technician – Billing Specialist will be responsible for processing customer bills and insurance claims accurately and providing excellent customer service to patients and medical providers.

Assisted LivingElder CareHealth CareNursing and Residential Care

Responsibilities

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. Uses working knowledge to troubleshoot and resolve customer service issues
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 payment arrangements
Research, identify and organize requested audit documentation in timely manner
Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed. Make corrections as needed and rebill claims as necessary
Through prior experience and cross training, demonstrate knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances) and working/functional knowledge of other pharmacy departmental functions
Exercise proficiency in the utilization of pharmacy information systems to meet operational needs and regulatory requirements. This includes using pharmacy systems to process prior authorizations, resolve rejections, produce various reports as necessary, and complete billing functions in a timely manner and with a high degree of accuracy
Consistently meet pharmacy's established accuracy and productivity levels
Follow all applicable government regulations including HIPAA
Work as a collaborative team member to meet the service goals of the pharmacy
Other essential functions and duties may be assigned as needed

Qualification

Pharmacy Technician CertificationBilling experiencePharmacy information systemsCustomer service skillsAttention to detailRelational skillsStrategyPlanningProblem solvingTeam orientedWork ethic

Required

Pharmacy Technician Certification required
High School Diploma or GED required
Pharmacy Technician license/certification/registration per state requirements
2 + years related experience including a minimum of 6 months billing experience in long term care or retail setting
Advanced computer skills; pharmacy information system experience required
Ability to work independently and deliver to deadlines
Great attention to detail and accuracy
Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines
Quality minded; motivated to seek out errors and inquire about inaccuracies
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

Preferred

National Certification preferred (PTCB) may be required (pharmacy specific)

Benefits

401(k) with up to 3.5% company match
Multiple health plan options including copay (FSA-eligible) and HSA eligible plans
Wellness Incentive Program
Dental and Vision plans
Company-paid basic life, AD&D and long-term disability coverage
Optional employee, spouse, and child life/AD&D insurance
Optional accident, critical illness, and short-term disability coverage
Dependent Care Flexible Spending Accounts
Employee Assistance Program (EAP)
Paid holidays and sick days
Generous vacation benefits based on years of service

Company

Guardian Pharmacy

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Guardian Pharmacy offers medication management services for long-term pharmacy care.

Funding

Current Stage
Public Company
Total Funding
$217.5M
Key Investors
Regions Bank
2025-05-22Post Ipo Secondary· $157.5M
2024-09-26IPO
2018-07-16Debt Financing· $60M

Leadership Team

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Doug Towns
Vice President, General Counsel & Senior Compliance Officer
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Jeff Tuch
VP - Purchasing & Payor Relations
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Company data provided by crunchbase