Pharmacy Biller MedBox
Share
Job Location:
Laguna Hills, CA - USA
Hourly Salary:
$ 24 - 27
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Make an Impact Beyond Billing
At AmeriPharma MedBox we dont just dispense medication we ensure patients receive the therapies they depend on on time every month. As a Pharmacy Biller you will play a critical role in keeping medications moving from insurance approval to production and ultimately to the patients is not just a billing function it is a key position within our care delivery process. Your work ensures prescriptions are approved and ready for production enabling timely dispensing and positively impacting patient health outcomes.
If you enjoy solving insurance challenges navigating payer requirements and working in a fast-paced pharmacy environment where your expertise truly matters this role is for you.
About Us
AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas creativity and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.
AmeriPharmas Mission Statement
Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients prescribers colleagues and others that We Care!
Our Benefits Packages
- Full benefits package including medical dental vision life that fits your lifestyle and goals
- Great pay and general compensation structures
- Employee assistance program to assist with mental health legal questions financial counseling etc.
- Comprehensive PTO and sick leave options
- 401k program
- Plenty of opportunities for growth and advancement
- Company sponsored outings and team-building events
- Casual Fridays
What Youll Do
- Own the monthly claims process that triggers medication production and dispensing.
- Submit adjudicate and rebill pharmacy claims accurately and efficiently.
- Resolve claim rejections and secure necessary overrides from PBMs.
- Manage prior authorizations and coordinate with providers for timely approvals.
- Communicate clearly with patients regarding insurance-related matters.
- Ensure compliance with Medicare Part D Medicaid and commercial payer requirements.
- Identify billing trends and proactively prevent recurring rejections.
Why This Role Matters
- Your work directly impacts whether patients receive their medications on time by ensuring timely payment processing minimizing delays in production and dispensing.
- You collaborate with pharmacy operations production and insurance teams
- You become a subject matter expert in complex payer systems.
Schedule Details
- Location: On-Site Laguna Hills CA (Office borders Irvine)
- Hours: 8 hour shifts 5 days a week: Monday Friday 8:30 AM 5:00 PM or 7:00AM - 5:00PM Saturday 7:30AM - 4:00PM (rotating)
Required Skills & Qualifications
- Minimum of 1 year of direct hands-on experience with third-party billing claims submission prior authorization and rejection resolution.
- Direct experience with third-party billing claim submission rejection resolution and prior authorizations.
- Expertise in navigating complex payer requirements including Medicare Medicaid and private insurance plans.
- High attention to detail and strong organizational skills.
- Ability to prioritize and work independently in a high-volume environment.
- Professional communication skills when working with patients and peers.
- Strong analytical skills and the ability to handle sensitive patient information with discretion.
Preferred Qualifications
- Licensed or Registered Pharmacy Technician
- Experience with multi-state or out-of-state insurance plans
- Experience in long-term care specialty pharmacy or high-volume settings
Education Requirements
- High School Diploma or equivalent (required)
- Familiarity with NCPDP standards PBMs and claim processing
- Preferred: Licensed/Registered Pharmacy Technician
- Preferred: Experience working with out-of-state insurance plans
Who Thrives Here
- Problem-solvers who enjoy tackling complex insurance scenarios
- Detail-oriented professionals who understand the financial impact of accuracy
- Individuals who want their work to directly influence patient care
- Team players who value accountability and ownership
Physical Requirements
The following physical activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions and expectations
EEO Statement
The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be anexhaustive list of all responsibilities duties and skills required. The duties and responsibilities of this position are subject to change and otherduties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO qualified applicants will receive consideration for employment without regard to race sex color religion sexual orientation gender identity national origin age protected veteran status or on the basis of disability or any other legally protected class.
Required Experience:
Junior IC
Key Skills
About Company
AmeriPharma is a fully accredited pharmacy, overarching four distinct divisions: Long Term Care, MedBox, Specialty Care, and Infusion Center.
