Job Details

Pharmacy Billing Specialist

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Ensures accurate and timely billing for pharmacy-related services. Prepares and submits claims to insurance providers, resolves billing discrepancies, and works with patients, payers, and internal teams to ensure prompt reimbursement and minimize claim denials.

Job Requirements:

Education and Work Experience:

• High School Education/GED or equivalent: Preferred
• Associate's/Technical Degree or equivalent combination of education/related experience: Preferred
• Five years' relevant experience: Preferred
• Experience and familiarity with pharmacy terminology and coding standards (e.g., NCPDP, HCPCS, ICD-10): Preferred

Licenses/Certifications:

• Retail pharmacy billing training course: Required
• RPBC: Required

Essential Functions:

• Reviews financial statements to identify and correct payment inconsistencies or errors. Posts charges and payments to ensure all billing entries are accurate and compliant.
• Prepares and issues invoices and billing documentation to customers or patients. Submits billing data and claims to appropriate insurance providers.
• Tracks and processes insurance claims from submission to payment. Investigates and resolves denial instances to ensure maximum reimbursement.
• Monitors and implements billing procedures and systems that support compliance and efficiency.
• Supports the deployment and reporting of pharmacy-related billing programs and initiatives.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Job Identification: 52134

Job Category: Associate

Locations: ONE Adventist Health Way, Roseville, CA, 95661, US

Assignment Category: Full-time regular

Pay Range: The estimated base pay for this position is $24.03 to $30.91. Additional individual compensation may be available for this role through differentials, extra shift incentives, bonuses, etc. Base pay is only a portion of the total rewards package, and a comprehensive benefits program is available for qualifying positions. Please contact our Talent Acquisition team for more information.

Hiring Department: Finance Controllership

Shift Length: 8 Hours