Pharmacy Billing Clerk

Sacramento, CA

Pharmacy Billing Clerk - Sacramento, CA

Compensation: $18 - $22 Hourly 

Overview: Nexus HR is looking for a Pharmacy Billing Clerk with strong experience working in a fast-paced Long-Term Care and Assisted Living pharmacy in Sacramento.

About the Job:

The Pharmacy Billing Clerk is responsible for efficiently managing billing operations. This role involves processing claims, posting payments, following up on balances, and maintaining strong communication with patients and facility staff.

Duties and Responsibilities:

  • Accurately prepare, submit, and track insurance claims for medications dispensed to long-term care and institutional patients.

  • Verify insurance eligibility, prepare and submit claims, and post payments accurately.

  • Generate statements of accounts and follow up on unpaid balances with patients and facility staff.

  • Handle billing inquiries, explain charges, and collect payments professionally.

  • Resolve denied claims by coordinating with insurance providers or PBMs.

  • Maintain accurate billing records and prepare reports as needed.

  • Perform general administrative tasks, including MS Word & Excel, email correspondence, and managing office supplies.

Qualifications:

  • High school diploma or equivalent required; Associate degree in healthcare administration, accounting, or related field preferred.

  • Minimum 1 year of pharmacy billing.

  • In-depth knowledge of insurance requirements.

  • Strong proficiency in Pharmacy Management Software (IPS - Intelligent Pharmacy Software ), Point of Sale (QS1), and Microsoft Suite; or comparable software/s.

  • Excellent analytical, organizational, and problem-solving skills.

  • Strong communication skills with the ability to interact professionally with healthcare providers and facility staff.

  • High attention to detail and accuracy in data entry and financial reconciliation.

Qualifications:

  • Dental, Vision, and Health Insurance

  • PTO and Sick Leave

  • 401k