Billing Specialist

Overview Eden Prairie, Minnesota – Guardian Pharmacy of Minnesota is a rapidly growing member of the Guardian family of pharmacies, providing innovative long‑term care pharmacy services. This role offers a starting pay range of $23–$27 and the opportunity to grow within a supportive, diverse, and inclusive environment. Responsibilities Process customer bills and insurance claims accurately and in a timely manner, including daily and month‑end billing functions, procedures, and reporting. Provide excellent customer service to patients, caregivers, medical providers, and insurance carriers. Research and establish patient eligibility coverage with private and government insurance providers; reverify benefit coverage criteria as needed for claim follow‑up. Enter and update patient and insurance information in the billing system; maintain and audit patient files and supporting documentation for third‑party audits and payer compliance. Resolve patient billing issues related to insurance eligibility, coverage, and benefits; provide guidance during Medicare and special enrollment periods. Review patient profiles, drug regimens, and insurance coverage to identify cost‑saving opportunities. Complete daily census, admissions, discharges, and room changes for assigned facilities. Process patient payments, returns, and credits; transmit credit card payments and pursue delinquent accounts. Research, identify, and organize audit documentation in a timely manner. Perform prescription claim adjudication, communicate with insurance companies regarding rejected claims, eligibility, prior authorizations, or other issues, and rebill as necessary. Develop knowledge of pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans, and third‑party insurances) and proficiency in pharmacy information systems to meet operational needs and regulatory requirements. Rotate through other departments to gain functional knowledge of related workflows and support overall service goals. Follow all applicable government regulations, including HIPAA. Qualifications High School Diploma or GED required. Active Minnesota pharmacy technician license. One or more years of related experience. Advanced computer skills and pharmacy information system experience preferred. National Pharmacy Technician Certification (PTCB) preferred and may be required. Ability to work independently, meet deadlines, and handle multiple tasks in a fast‑paced, team‑oriented environment. Excellent attention to detail, quality orientation, and a motivation to seek out errors. Attributes Work ethic and integrity with intrinsic drive to excel. Relational skill to build trust with business unit management. Strategic planning ability to think ahead and manage time efficiently. Problem‑solving skill to analyze causes and resolve issues at the functional level. Team orientation to collaborate effectively with all team members. Benefits Guardian offers a comprehensive Total Rewards package, including competitive compensation, a 401(k) plan with company match, full‑time health, dental, and vision insurance, health savings and flexible spending accounts, company‑paid life and disability coverage, voluntary life and critical illness plans, dependent care options, wellbeing and employee assistance programs, paid holidays and sick days, and generous vacation benefits based on tenure. Work Environment Desk work in an office setting with low to moderate noise levels. The role requires flexible work hours, effective interpersonal communication, conflict management, and the ability to handle stressful situations and deadlines. Equal Opportunity Employer Guardian Pharmacy Services is an equal‑opportunity employer and provides equal opportunity in employment for all qualified persons, without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law. #J-18808-Ljbffr