Pharmacy Billing Specialist

About the Role

As a Pharmacy Claims Specialist, you will collaborate with dedicated professionals internally and externally, supporting Devereux’s National Center and Centers nationwide with pharmacy-related claims. This role offers a supportive, collegial work atmosphere with the ability to deliver high-quality, data-driven financial decisions. The salary range for this position is $17.22 to $19.64 per hour.

Quality Health Pharmacy (QHP), a division of Devereux, was founded in 1992 and operates pharmacy programs in Cherry Hill, NJ; Orlando, FL; and League City, TX. Under the guidance of the Vice President for Pharmacy, this role will provide billing support to Worcester and surrounding communities, ensuring alignment with best practices and all applicable regulatory, accreditation, and professional pharmacy standards.

Responsibilities

• Perform timely preparation and electronic submission of claims to third-party carriers and guarantors.
• Conduct utilization review and correction of rejected claims, answering inquiries on a timely basis.
• Complete and submit pharmacy documents and paperwork, including electronic records, reports, monthly medication charge, and usage reports.
• Assist in setting up contracts, Medicaid applications, and renewals.
• Communicate with funding agencies, including private payers, regarding claim processing procedures and payment difficulties.
• Prepare and disseminate information requested by government agencies and external auditors.
• Research non-applied credit line items.
• Perform system integrity checks and maintenance, and coordinate responses to internal and external audit requests.

Qualifications

• High School Diploma or G.E.D. (some college coursework is highly preferred).
• Pharmacy Technician Certification is preferred.
• Minimum of three years of experience in pharmacy and/or performing pharmacy insurance billing and collection duties is preferred.
• Pharmacy pricing and medication knowledge is preferred.
• Computer proficiency in Microsoft Office products.
• Strong customer service skills and the ability to work effectively in a cross-functional team environment.
• Ability to multitask and meet deadlines in a fast-paced environment.
• Valid driver’s license and access to a car is required.

Benefits

• ASCEND – Career Accelerator Program: Personalized coaching and financial assistance to help you reach your full potential.
• Comprehensive Health and Welfare Program: Medical (including telemedicine), dental, prescription drug, preventative care, and mental health services. Visit mydevereuxbenefits.org for details.
• Student loan debt assistance, tuition reimbursement, and continuing education assistance.
• Generous time-off (accrued from the first day), 403(b) retirement plan with matching benefit, and voluntary/employee-paid supplemental life and accident coverage.
• Employee assistance/work-life balance program.

About Devereux

Devereux is one of the nation’s largest nonprofit organizations, providing services, insight, and leadership in behavioral healthcare. Founded in 1912, Devereux operates a comprehensive national network of clinical, therapeutic, educational, and employment programs that positively impact the lives of over 10,000 children, adults, and their families annually.

Our mission is to unlock and nurture human potential for people living with emotional, behavioral, or cognitive differences. With nearly 6,500 employees across the country, Devereux serves individuals in areas such as autism, intellectual and developmental disabilities, specialty mental health, education, and foster care.

At Devereux, Servant Leadership is embedded in our culture, emphasizing a mission-driven, people-first mindset. We foster an inclusive workplace where open dialogue and brave spaces create opportunities to change lives—one person, one family, and one community at a time.