Billing Specialist

Independent Health Association • Buffalo, NY

7d • Hybrid

About The Position

The Billing Specialist supports pharmacy operations by completing pharmacy and medical claims billing, adjudicating rejections, and helping ensure billing accuracy and timely delivery. The position also serves as a liaison among patients, insurance companies, physicians, medical staff, administrative staff, and payors to resolve billing issues and coordinate patient care and financial assistance. The role follows written procedures and guidelines, with deviations requiring approval from the supervising pharmacist.

This is a hybrid position based at the Williamsville location. It begins with three months of onsite training, followed by three onsite days and two remote days each week. The standard schedule is Monday through Friday, 8:30 a.m. to 5:00 p.m. After training, the schedule includes one opening shift, two mid-shifts, and two closing shifts per week. Associates working evening hours after 6 p.m. are eligible for a shift differential. The position is hourly and non-exempt. Sponsorship for immigration or work visas is not provided.

Requirements

• High school diploma or GED.
• At least one year of experience working in a high-volume pharmacy or equivalent setting, or six months as a temporary associate in the Reliance Rx Operations & Compliance department.
• Effective oral and written communication skills.
• Aptitude for working with other health care professionals.
• Ability to lift a minimum of 5 pounds.
• Examples of displaying Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive.

Nice To Haves

• National Pharmacy Technician Certification (CPhT).
• Experience working with an online claims processing system.

Responsibilities

• Bill pharmacy and medical claims, manage rejections, and ensure appropriate follow-up and delivery timelines.
• Act as a liaison between patients and insurance companies and facilitate communication among patients, doctors, medical staff, and administrative staff.
• Work with payors to resolve billing issues.
• Ensure compliance with CMS guidelines for Medicare and Medicaid.
• Confirm billing accuracy and payor billing and shipping requirements.
• Process and set up deliveries to medical offices.
• Bill medical claims for supplies and medications.
• Confirm financial aspects of claims before they leave the facility.
• Manage portals, including sending refill reminders, processing portal orders, and registering patients.
• Coordinate financial assistance with patients, including foundation care, copay assistance, and free medication programs where applicable.
• Assist Patient Care Specialists with workflow and incoming and outgoing calls as business needs require.
• Maintain patient records and perform filing and documentation duties.
• Perform setup and data entry.
• Arrange financial agreements and collect copayments.
• Assist offices with prior authorizations.
• Coordinate benefits.
• Promote information sharing and continuous process improvement.
• Follow standard written procedures and guidelines; obtain supervising pharmacist approval for deviations.

Benefits

• Eligible for a scorecard incentive.
• Full range of benefits.
• Generous paid time off.
• Shift differential for associates working evening hours after 6 p.m.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED