Talent.com
Billing Specialist

Billing Specialist

Guardian Pharmacy ServicesKnoxville, TN, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Extraordinary Care. Extraordinary Careers.

With one of the nation's largest, most innovative long-term care pharmacy services providers, there is no limit to the growth of your career.

East Tennessee Pharmacy Services, a member of the Guardian family of pharmacies, has an exciting opportunity for you to join our rapidly growing team in Knoxville, Tennessee.

Why East Tennessee Pharmacy Services? We're reimagining medication management and transforming care.

Who We Are and What We're About :

Our core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.

We offer an opportunity to learn and grow your career in a fast-paced, diverse, and inclusive environment. If you are looking for a challenging, team-oriented environment in which you can put your expertise to work, then this is the place for you.

Schedule :

Rotating shifts (7-4, 8-5, 9-6) and rotating holiday and weekend coverage

Responsible for processing customer bills and insurance claims in an accurate and timely manner. This includes assisting with all daily and month-end billing functions, procedures and reporting. Provides excellent customer service to patients, caregivers, medical providers and insurance carriers.

Attributes Required :

  • Work Ethic / Integrity must possess intrinsic drive to excel coupled with values in line with company philosophy
  • Relational ability to build relationships with business unit management and become "trusted advisor."
  • Strategy and Planning ability to think ahead, plan and manage time efficiently.
  • Problem Solving ability to analyze causes and solve problems at functional level.
  • Team Oriented ability to work effectively and collaboratively with all team members.

Essential Job Functions (include the following) :

  • Research and establish patient eligibility coverage with insurance providers including private individuals and / or government entities. Reverify benefit coverage criteria as needed for claims follow up. Accurately enters and / or updates patient / insurance information into billing system.
  • Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance. Accurately enter patient information into the pharmacy system.
  • Provide assistance and timely response to all billing customer inquiries via phone or electronic communications. Research and resolve patient billing issues regarding insurance eligibility, coverage, and related benefits.
  • Provide guidance and support to resident or responsible party by running Medicare plan comparisons during open enrollment and special enrollment periods. Proactively review patient profiles, drug regimens and insurance coverage to evaluate options to save resident money.
  • Responsible for completion of daily census, admit, discharge, and room changes for the facilities assigned.
  • Process patient payments, returns, and credits. Transmit individual credit card payments as needed.
  • May pursue payment from delinquent accounts and make payment arrangements.
  • Research, identify and organize requested audit documentation in timely manner.
  • Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed. Make corrections as needed and rebill claims as necessary.
  • Develop knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances)
  • Develop proficiency in the utilization of pharmacy information systems to meet operational needs and regulatory requirements. This includes using pharmacy systems to process prior authorizations, resolve rejections, produce various reports as necessary, and complete billing functions.
  • Rotate through other departments to gain working / functional knowledge of other department workflows.
  • Follow all applicable government regulations including HIPAA.
  • Work as a collaborative team member to meet the service goals of the pharmacy.
  • Other essential functions and duties may be assigned as needed.
  • Education and / or Certifications :

  • High School Diploma or GED required.
  • Pharmacy Technician license / certification / registration per state requirements; National Certification preferred (PTCB) may be required (pharmacy specific).
  • Skills and Qualifications :

  • 1+ years of related experience
  • Advanced computer skills; pharmacy information system experience preferred.
  • Ability to work independently and deliver to deadlines.
  • Great attention to detail and accuracy
  • Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines
  • Quality minded; motivated to seek out errors and inquire about inaccuracies.
  • Work Environment :

  • The noise level in the work environment is usually low to moderate.
  • Due to the collaborative nature of the business and the need to service customers, the employee must be able to interact effectively with others in an office environment, manage conflict, and handle stressful situations and deadlines.
  • Requires desk work in office environment.
  • Ability to work flexible hours.
  • What We Offer :

    Guardian provides employees with a comprehensive Total Rewards package, supporting our core value of, "Treat others as you would like to be treated." Compensation & Financial

  • Competitive pay
  • 401(k) with company match
  • Family, Health & Insurance Benefits (Full-Time employees working 30+ hours / week only)

  • Medical, Dental and Vision
  • Health Savings Accounts and Flexible Spending Accounts
  • Company-paid Basic Life and Accidental Death & Dismemberment
  • Company-paid Long-Term Disability and optional Short-Term Disability
  • Voluntary Employee and Dependent Life, Accident and Critical Illness
  • Dependent Care Flexible Spending Accounts
  • Wellbeing

  • Employee Assistance Program (EAP)
  • Guardian Angels (Employee assistance fund)
  • Time Off

  • Paid holidays and sick days
  • Generous vacation benefits based on years of service
  • The Guardian Difference

    Our clients require pharmacy services that aren't "cookie cutter." That's why every Guardian pharmacy is locally operated and empowered with the autonomy to tailor their business to meet their clients' needs.

    Our corporate support offices, based in Atlanta, Ga., provide services such as human resources, business intelligence, legal, and marketing to promote the success of each Guardian location.

    Regardless of your role at Guardian, your voice and talents matter. Because healthcare is an ever-changing industry, we encourage innovative thinking, intellectual curiosity, and diverse viewpoints to ensure we stay competitive in today's dynamic business environment.

    At Guardian, we are dedicated to fostering and advancing a diverse and inclusive workforce.

    Join us to discover what your best work truly looks like.

    serp_jobs.job_alerts.create_a_job

    Billing Specialist • Knoxville, TN, US

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Illinois Medicaid Billing Specialist

    Illinois Medicaid Billing Specialist

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Denial Resolution Specialist.Key Responsibilities Manage and execute all billing functions, focusing on Illinois Medicaid billing Oversee claims management, documentat...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Illinois Licensed Billing Specialist

    Illinois Licensed Billing Specialist

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Billing Specialist who will manage and execute all billing functions within skilled nursing facilities, focusing on Illinois Medicaid billing.Key Responsibilities Manag...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Payroll & Billing Specialist

    Payroll & Billing Specialist

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Payroll & Billing Specialist (Full Time, Remote).Key Responsibilities Process semi-monthly payroll and ensure compliance with tax regulations Prepare and send invoices...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Billing Assistant

    Billing Assistant

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Billing Assistant (Virtual or Hybrid).Key Responsibilities : Prepare and review invoices, ensuring accurate billing and timely entry of client expenses Coordinate with ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Senior Billing Clerk

    Senior Billing Clerk

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Senior Billing Clerk / Patient Account Representative for Commercial Insurance Professional Receivables. Key Responsibilities Status patient accounts for nonpayment from C...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Illinois Medicare Billing Specialist

    Illinois Medicare Billing Specialist

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a MCR Billing Specialist.Key Responsibilities : Prepare, review, and submit Medicare Part A & B claims for skilled nursing residents Ensure timely and accurate billing in...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Billing EDI Analyst

    Billing EDI Analyst

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Billing EDI Analyst - REMOTE.Key Responsibilities Verify payer member rosters are accurately loaded in the internal database Proactively research, troubleshoot, and re...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    eBilling Supervisor

    eBilling Supervisor

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for an eBilling Supervisor (Remote).Key Responsibilities Supervise e-billing employees to ensure quality service delivery and client satisfaction Manage staffing and workflo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Billing Specialist

    Billing Specialist

    NHC HealthCare ColumbiaKnoxville, TN, US
    serp_jobs.job_card.full_time
    The Billing Specialist is responsible to generate and bill clean claims, as well as, for follow-up of timely and accurate payments of patient accounts. At Caris, you will have a career, not just a j...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Travel MRI Tech - $2626 / Week

    Travel MRI Tech - $2626 / Week

    Cynet HealthMaryville, TN, US
    serp_jobs.job_card.full_time
    Cynet Health is seeking an experienced MRI Tech for an exciting Travel Allied job in Maryville, TN.Shift : 5x8 hr PMs Start Date : 11 / 10 / 2025 Duration : 13 weeks Pay : $2626 / Week.Ranked #5 Best Trave...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Billing Specialist

    Billing Specialist

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Billing Specialist to support their Specialty Infusion Pharmacy remotely.Key Responsibilities Prepare and submit accurate medical claims based on payer agreements Revi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Illinois Licensed HCBS Billing Specialist

    Illinois Licensed HCBS Billing Specialist

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for an HCBS Billing Specialist who will manage billing and claims for Home and Community-Based Services. Key Responsibilities : Prepare and submit accurate billing claims for H...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Senior e-Billing Analyst

    Senior e-Billing Analyst

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Senior e-Billing Analyst (Remote).Key Responsibilities Manage all aspects of client billing including preparation and submission of electronic invoices Act as a liaiso...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Advertised Medical Biller

    Advertised Medical Biller

    Covenant HealthKnoxville, TN, US
    serp_jobs.job_card.full_time
    Full Time, 80 Hours Per Pay Period, Day Shift.Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Billing Specialist II

    Billing Specialist II

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Billing Specialist II to join their Finance team.Key Responsibilities Prepare and submit client invoices monthly according to contract terms and company policies Maint...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Billing Technical Supervisor

    Billing Technical Supervisor

    VirtualVocationsKnoxville, Tennessee, United States
    serp_jobs.job_card.full_time
    A company is looking for a Billing Technical Supervisor (Remote).Key Responsibilities Supervise technical operations of the Billing department to ensure accurate and efficient processing of billi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Travel MRI Tech - $2752.62 / Week

    Travel MRI Tech - $2752.62 / Week

    Pulse Healthcare ServicesMaryville, TN, US
    serp_jobs.job_card.full_time
    Pulse Healthcare Services is seeking an experienced MRI Tech for an exciting Travel Allied job in Maryville, TN.Shift : 5x8 hr PMs Start Date : 11 / 10 / 2025 Duration : 13 weeks Pay : $2752.About Pulse He...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Travel MRI Tech - $2496 / Week

    Travel MRI Tech - $2496 / Week

    Premier Medical Staffing Services, LLCMaryville, TN, US
    serp_jobs.job_card.full_time
    Premier Medical Staffing Services, LLC is seeking an experienced MRI Tech for an exciting Travel Allied job in Maryville, TN. Shift : 5x8 hr PMs Start Date : 11 / 10 / 2025 Duration : 13 weeks Pay : $2496 / ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days