Pharmacy Billing Specialist

Pharmacy Billing SpecialistThe Pharmacy Billing Specialist supports a long-term care pharmacy by accurately managing insurance billing and patient account activities for residents in nursing homes, assisted living facilities, and group homes. This role focuses on verifying insurance coverage, resolving claim issues, and maintaining compliant documentation while collaborating closely with the pharmacy team to ensure timely and accurate prescription billing and excellent service to patients and facilities.Responsibilities:Verify patient insurance eligibility, benefits, and coverage with private and government payers.Accurately enter and maintain patient, insurance, and billing information in pharmacy systems.Research and resolve billing issues, including rejected prescription claims, prior authorizations, and insurance discrepancies.Process and rebill prescription claims as needed, communicating with insurance providers to resolve issues promptly.Assist patients or responsible parties with Medicare plan comparisons and identify potential cost-saving coverage options.Maintain compliant patient documentation and prepare records and reports for third-party audits.Complete facility census updates, including admissions, discharges, and room or bed changes.Process patient payments, credits, returns, and credit card transactions accurately and securely.Support collection efforts and payment arrangements for delinquent accounts as needed.Maintain up-to-date knowledge of Medicare, Medicaid, Prescription Drug Plans (PDPs), and third-party insurance billing requirements.Utilize pharmacy systems to perform billing functions, process prior authorizations, resolve claim issues, and generate reports.Follow all applicable regulations and requirements, including HIPAA and other pharmacy-related guidelines.Collaborate with pharmacy team members to meet service, quality, and operational goals in a fast-paced environment.Essential Skills:High school diploma or GED.Pharmacy technician license, certification, or registration as required by the state.1+ years of customer service experience.2+ years of retail pharmacy experience.Advanced computer skills, including experience with pharmacy operations systems (preferred or required as applicable).Strong data entry skills with high accuracy and attention to detail.Ability to work independently and consistently meet deadlines.Ability to solve problems with minimal direction and sound judgment.Ability to manage multiple tasks simultaneously while adhering to strict timelines.Quality-focused mindset with motivation to identify errors and question information that appears inaccurate.Knowledge of medications, prescriptions, and pharmacy workflows.Ability to excel in a fast-paced, team-oriented environment.Additional Skills & Qualifications:Associate degree preferred.National pharmacy technician certification (such as PTCB) preferred and may be required depending on pharmacy-specific needs.Long-term care or retail pharmacy technician or billing experience preferred but not required.Experience working with Medicare, Medicaid, and Prescription Drug Plans (PDPs) is beneficial.Certified Pharmacy Technician (CPhT) credential is a plus.Strong communication skills for interacting with patients, responsible parties, facilities, and insurance providers.Comfort working with medical and pharmacy terminology.Service-oriented mindset and commitment to supporting residents in long-term care settings.Work Environment:This position is based in a long-term care pharmacy environment, supporting prescription services for nursing homes, assisted living facilities, and group homes rather than a traditional retail pharmacy. The role is primarily computer-based, requiring the ability to sit and perform detailed computer and billing work for extended periods of time. The schedule is full-time at 40 hours per week, working an 8-hour shift between 8:00 a.m. and 7:00 p.m. The role includes working approximately every fourth weekend, with typical weekend hours of Saturday 9:00 a.m.3:00 p.m. and Sunday 10:00 a.m.2:00 p.m. The week leading up to a scheduled weekend includes one weekday off and a reduction of about half an hour from other shifts to maintain a 40-hour workweek. Occasional additional weekend coverage may be needed, so schedule flexibility is important. The dress code is casual; team members may wear jeans and T-shirts, with closed-toe shoes required. Shorts are permitted if they are of appropriate length, and tops should provide appropriate shoulder coverage. The environment is team-oriented and fast-paced, with a focus on accuracy, compliance, and supporting residents medication needs in a professional and collaborative setting.Job Type & Location:This is a Contract to Hire position based out of Cedar Rapids, IA.Pay and Benefits:The pay range for this position is $22.00 - $25.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)Application Deadline:This position is anticipated to close on Oct 29, 2026.Workplace Type:This is a fully onsite position in Cedar Rapids, IA.About Actalent:Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email View email address on click.appcast.io for other accommodation options.San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.