NO REMOTE. ON SITE ONLY IN COLOMBIA.
Pharmacy Billing Specialist
U.S. Pharmacy Operations | Long-Term Care
Location: Colombia, ON SITE ONLY. NO REMOTE. City to be shared during screening
Work arrangement: ON SITE ONLY. NO REMOTE WORK. Candidates must live in or be able to relocate to the on-site city at their own cost before starting.
Schedule: Assigned U.S. hours; exact shift confirmed during screening
Staffingly, Inc. is seeking an experienced Pharmacy Billing Specialist to support U.S. pharmacy operations serving long-term care and other healthcare facilities. You will help process prescription claims accurately, resolve insurance rejections, follow up on billing issues and keep pharmacy and facility teams informed.
This role requires hands-on prescription-billing experience. Strong communication and careful follow-through are essential when working with pharmacy staff, facilities, insurance plans and pharmacy benefit managers (PBMs).
What you will do
- Process prescription claims: bill regular and specialty medications; verify patient, prescriber, prescription and insurance information before submitting claims through approved systems.
- Check coverage: confirm pharmacy benefits, eligibility and payer details; identify missing or conflicting information and flag coverage issues promptly.
- Resolve insurance rejections: investigate issues such as incorrect member details, refill-too-soon messages, quantity limits, coverage restrictions and prior-authorization requirements, then correct and reprocess within approved procedures.
- Coordinate payer follow-up: contact insurance plans and PBM help desks, document reference numbers and required actions, and coordinate missing information with pharmacy or facility staff.
- Calculate days' supply and enter data:
use approved prescription directions and SIG codes to calculate days' supply and enter authorized prescription-label information.
- Support facility billing: research hospital or facility billing questions, reconcile account discrepancies and help route charges to the appropriate account.
- Manage outstanding work: track rejected, unpaid or reversed claims, follow-up dates and escalation owners.
- Communicate clearly: handle billing calls and messages professionally, explain administrative next steps and provide accurate updates without promising coverage or payment.
- Maintain quality and privacy: keep complete account notes, meet agreed accuracy and turnaround standards, and follow HIPAA-related privacy, security and approved-access procedures.
ON SITE REQUIREMENTS (NO REMOTE) This role is ON SITE ONLY in Colombia. NO REMOTE WORK. Applicants must be based in Colombia, able to work from the office every working day, and available for the assigned U.S. schedule. Compliance with company device and secure-access requirements is required. Exact shift, compensation and engagement terms will be discussed during recruitment.
Required qualifications
- 3-5+ years of hands-on prescription-billing experience, including U.S. pharmacy insurance claims, rejection resolution and claim correction or resubmission.
- Experience with facility or hospital billing and communicating with pharmacy, payer or facility teams about billing issues.
- Practical knowledge of days' supply calculations, SIG codes and accurate prescription-data entry under approved pharmacy procedures.
- Strong spoken and written English for U.S. pharmacy, payer and facility communication; excellent telephone and customer-service skills.
- Proficiency with Microsoft Outlook, Word and Excel, plus browser-based billing systems and payer portals.
- Strong attention to detail, organization and prioritization; ability to work independently within an on-site team.
Preferred experience
- Retail and/or specialty pharmacy billing; long-term care pharmacy or skilled nursing facility workflows.
- Familiarity with Medicare Part D, Medicaid and commercial pharmacy/PBM billing, coordination of benefits and facility-versus-payer billing workflows.
- Administrative prior-authorization follow-up, billing reconciliation and outstanding-claim worklists.
- English-Spanish bilingual communication is an advantage.
How to apply Apply on LinkedIn, or email your current resume to
[email protected] with the subject "Pharmacy Billing Specialist - Colombia ON SITE". Include your city in Colombia, confirmation that you can work ON SITE (no remote), English level, earliest start date and availability for U.S. hours, plus your years of U.S. prescription-billing experience and one insurance rejection you personally resolved using no patient-identifying information.
Screening for this role is supported by an AI recruiting assistant. I am an AI; if you find any errors, please report to
[email protected] (do not CC this email).
Staffingly, Inc. Healthcare Recruitment | Colombia, ON SITE ONLY, NO REMOTE
Posted by the AI Recruiter. I am an AI; if you find any errors, please report to
[email protected].
📌 Pharmacy Billing Specialist (Bogotá)
🏢 Staffingly
📍 Bogotá