Pharmacy Billing/Biller

About AmeriPharma

AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.

AmeriPharma’s Benefits

• Full benefits package including medical, dental, vision, life that fits your lifestyle and goals


• Great pay and general compensation structures


• Employee assistance program to assist with mental health, legal questions, financial counseling etc.


• Comprehensive PTO and sick leave options


• 401k program


• Plenty of opportunities for growth and advancement


• Company sponsored outings and team-building events


• Casual Fridays

Job Summary:

As a Pharmacy Biller at AmeriPharma, you will be responsible for ensuring the accurate and timely billing of pharmacy services. You will handle interactions with third-party payers, including Pharmacy Benefit Managers (PBMs), as well as manage patient communications regarding insurance issues. Your role will focus on maintaining precise and up-to-date records, resolving billing discrepancies, ensuring accurate claim adjudication, and meeting all billing regulations. You will also ensure a high level of customer service and contribute to improving processes within the pharmacy benefit management framework. 

Schedule Details:

• On-Site (Laguna Hills, CA - Office borders Irvine)


• Monday-Friday, 8:30 AM - 5:00 PM

Duties and Responsibilities:

• Update and rebill National Drug Codes (NDCs) and ensure accurate billing for pharmacy claims. 


• Perform electronic billing adjudication for claims and address claim rejections.


• Contact insurance companies to resolve billing issues, including claim rejections and overrides. 


•  Manage prior authorization requests


• Work closely with both patients and payers to ensure the accurate adjudication of claims


• Collect copayments and ensure that all billing records are up-to-date. 


• Communicate with patients regarding insurance issues and ensure timely follow-up.
  

Required Skills/Qualifications:

• Minimum of 1 year of experience in retail or independent pharmacy


• Minimum of 2 years of experience in pharmacy billing and/or collections, with 2-3 years of experience in PBM billing.


• Strong ability to perform tasks accurately and efficiently


• Strong communication skills, both oral and written, with the ability to convey complex insurance issues clearly to patients and third parties.


• Strong ability to prioritize tasks and manage multiple projects simultaneously. 


• Ability to work independently, meet deadlines, and remain flexible
  

Education Requirements:

• High School Diploma or equivalent


• Preferred: Licensed/Registered Pharmacy Technician 

AmeriPharma’s Mission Statement 

Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care!

Physical Requirements 

The following physical activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions and expectations

EEO Statement 

The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.