Pharmacy Biller - MedBox

Make an Impact Beyond BillingAt AmeriPharma MedBox, we don't 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 patient's home. This 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 UsAmeriPharma 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.AmeriPharma's 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 PackagesFull benefits package including medical, dental, vision, life that fits your lifestyle and goalsGreat pay and general compensation structuresEmployee assistance program to assist with mental health, legal questions, financial counseling etc.Comprehensive PTO and sick leave options401k programPlenty of opportunities for growth and advancementCompany sponsored outings and team-building eventsCasual FridaysWhat You'll DoOwn 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 MattersYour 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 teamsYou become a subject matter expert in complex payer systems. Schedule DetailsLocation: 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 & QualificationsMinimum 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 QualificationsLicensed or Registered Pharmacy TechnicianExperience with multi-state or out-of-state insurance plansExperience in long-term care, specialty pharmacy, or high-volume settingsEducation RequirementsHigh School Diploma or equivalent (required)Familiarity with NCPDP standards, PBMs, and claim processingPreferred: Licensed/Registered Pharmacy TechnicianPreferred: Experience working with out-of-state insurance plansWho Thrives HereProblem-solvers who enjoy tackling complex insurance scenariosDetail-oriented professionals who understand the financial impact of accuracyIndividuals who want their work to directly influence patient careTeam players who value accountability and ownershipPhysical 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 expectationsEEO Statement The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All 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.

Created: 2026-04-15