Guardian Pharmacy of Birmingham 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.
Assists in the pharmacy claims, billing, and A/R processes as assigned. Provides excellent customer service to our residents, sponsors, and facility staff as it relates to billing inquiries.
- 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
- Team Oriented – ability to work effectively and collaboratively with all team members
- Maintain accurate and complete patient billing records
- Perform prescription claims adjudication for all pharmacy insurance programs
- Perform composite prescription batch processing within the pharmacy operating system
- Analyze and reprocess rejected claims by identifying why the claim rejected and making any necessary corrections (prior authorizations, updated insurance information, etc.) in a timely manner
- Complete and process prior authorization request forms
- Make outgoing calls to insurers, responsible parties and others to follow up on rejected claims and to gather accurate insurance information
- Answer incoming calls pertaining to billing inquiries; resolve issues or forward to appropriate authority
- Manage and communicate billing exceptions to other pharmacy departments to ensure minimal bottlenecks in the daily pharmacy workflow
- Generate and review pre-bill verification reports to ensure accurate and timely customer invoices
- Assist with various month end close processes
- Other essential functions and duties may be assigned as needed
Education: High School Diploma or G.E.D.
- CPhT preferred
- 3+ years of related experience (advanced degree may substitute for experience)
- Advanced computer skills; pharmacy operations system experience preferred/required
- Ability to work independently and deliver to deadlines
- Ability to solve problems with minimal direction
- 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 when something appears inaccurate
Flexible Schedule Required:
8 hour shift
Hours of operation are subject to change based on the needs of the pharmacy
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.