Pharmacy Business Support Specialist
Core
Reconciles pharmacy claims, manages patient billing and receivables, and ensures billing compliance for a retail pharmacy.
Role type
Administrative billing specialist
Builds
Accurate payment remittances and compliant billing records
Domain
Healthcare / Pharmacy Operations
Deliverable
dashboards & analysis
Required skills
Claims reconciliation, payment denial resolution, Medicare Part B documentation, patient billing management, financial reporting, vendor invoicing
Preferred skills
Pharmacy Technician experience, Financial analyst experience, CPhT certification
Technologies
Microsoft Excel, Microsoft Word, Microsoft Outlook, Adobe Pro, Payer portals, Banking portals
Responsibilities
Reconcile pharmacy claims to third-party payments; Track and report payments, receivables, and bad debt; Review EOBs and reconcile bank deposits; Utilize payer portals to research payment denials and contact payers to resolve issues; Submit manual claims and monitor claim status; Ensure Medicare Part B documentation is completed and maintained; Compile documentation for payer audits; Manage patient billing and generate invoice statements; Answer pharmacy billing phone line; Assist with payer credentialing; Submit pharmacy invoices for vendor payment; Generate monthly financial reports.
Seniority
Mid-level, hands-on IC
