Regional Billing Specialist

Kernersville, North Carolina, United States of America | Wytheville, Virginia, United States of America

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.

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.

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.

Regional Billing Specialist

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.

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:

Emotional well-being and physical health are important, which is why our employees receive a generous benefits package and a work culture that supports our core value of, “Treat others as you would like to be treated.”

Compensation & Financial

• Competitive pay
• 401(k) with up to 3.5% company match (1)

Family, Health & Insurance Benefits (1), (2)

• Multiple health plan options including copay (FSA-eligible) and HSA eligible plans
• Wellness Incentive Program
• Dental and Vision plans
• Company-paid basic life, AD&D and long-term disability coverage
• Optional employee, spouse, and child life/AD&D insurance
• Optional accident, critical illness, and short-term disability coverage
• Dependent Care Flexible Spending Accounts
• Employee Assistance Program (EAP)

Time Off 

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

(1) Eligibility begins the first of the month following 30 days of employment

(2) Full-time employees only, excluding EAP which is available to all Guardian employees

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.