Regional Billing Specialist

Regional Billing Specialist 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. Southern Pharmacy Services, a member of the Guardian family of pharmacies, has an exciting opportunity for you to join our rapidly growing team in Kernersville, North Carolina. Why Southern Pharmacy Services? We're reimagining medication management and transforming care. 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. Works directly with the Regional Billing Lead and Regional Billing Manager to execute various billing tasks for each of the pharmacy locations. Assisting in audit compliance, vaccine billing, Medicare open enrollment, ancillary billing charges, cost comparisons and other billing-related tasks. Schedule Needed: Monday - Friday 8:00am-5:00pm Attributes Required: Work Ethic/Integrity must possess intrinsic drive to excel coupled with values in line with company philosophy Strategy and Planning ability to think ahead, plan and manage time efficiently Problem Solving ability to analyze causes and solve problems at both a strategic and functional level with minimal direction Team Oriented ability to work effectively and collaboratively with all team members Detail Oriented ability to provide attention to detail Organizational ability to organize work around multiple priorities and deadlines Essential Job Functions (include the following): Assist in researching, identifying and organizing documentation related to the timely processing of PBM audit requests for all SPS locations Assist in monitoring and executing all billing-related functions surrounding vaccine clinics Create ancillary revenue billing transactions according to contract and pharmacy performance at required intervals (monthly, quarterly, etc..) Participate in special enrollment and open enrollment activities as needed Perform new admission medication cost reviews as needed Provide customer service to internal and external customers as needed Update and process low income subsidies as needed Any other responsibilities as directed by supervisor Education and/or Certifications: High School diploma required, college degree in business preferred Pharmacy Technician registration required; National Certification preferred (PTCB) Skills and Qualifications: Excellent computer skills, including MS Office (Excel, Word, Teams) Excellent verbal and written communication skills; professional demeanor Strong attention to detail and analysis skills Ability to maintain confidentiality at all levels Ability to work to deadlines and balance multiple priorities Strong work ethic and desire to excel Pharmacy experience required Collections and Adjudication experience preferred FrameworkLTC and FrameworkECM experience required Strong knowledge of 3rd party insurance requirements Strong knowledge of pharmacy documentation requirements preferred Work 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." Competitive pay 401(k) with company match Medical, Dental and Vision (Full-Time employees working 30+ hours/week only) 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 Paid holidays and sick days Generous vacation benefits based on years of service Employee Assistance Program (EAP) Guardian Angels (Employee assistance fund) 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.

Created: 2026-03-11