Job Description
Pharmacy Biller
The Pharmacy Biller is responsible for the accurate and timely processing of pharmacy billing and reimbursement activities. This role reviews claims, resolves denials, and supports patients with billing and insurance inquiries. The position collaborates closely with internal teams and third-party payors to ensure compliance with applicable regulations and supports the financial performance of the pharmacy.
Principal Activities & Responsibilities
- Prepares, submits, and monitors pharmacy billing claims to ensure accurate and timely reimbursement from third party payors.
- Researches, resolves, and follows up on denied or rejected claims, including initiating appeals when appropriate.
- Initiates and tracks prior authorizations to support successful medication claim processing.
- Contacts third-party payors via phone, email, or fax to follow up on outstanding accounts (30, 60, 90, or 120+ days).
- Posts p...