• Generate reports and extract information using TOTVS RM • Prepare and validate billings based on payroll data and financial controls • Prepare and verify Excel spreadsheets to calculate charges and compose billing • Issue tax invoices (notas fiscais) and invoices • Contact clients to send billing, clarify questions, and follow up on outstanding items • Manage client portfolio and outstanding billing balances • Update financial systems and reports • Support vendor, consultant, and client registration processes • Monitor administrative and financial controls of the operation • Handle large volumes of information and multiple simultaneous demands

• Extract monthly billing data from the Zum portal for all assigned accounts • Conduct a structured validation of portal data against Operations adjustment submissions for each account • Apply account-specific contract rules to validated billing data • Prepare invoices in NetSuite for each assigned account using fully validated billing data • Submit completed invoices to the Manager and operations stakeholders for review • Issue approved invoices to the designated district accounts payable contacts via NetSuite • Provide billing data, supporting documentation, and account context to the Sr. Manager in support of dispute investigations • Maintain organized, complete billing records for all assigned accounts • Identify and escalate recurring data quality issues or systemic patterns to the leadership

Role Description The Billing Specialist I will utilize master billing guides and other process instructions to review PCR to ensure medical necessity, reasonableness, level of service, ICD10 coding and mileage is correct. This role is fundamental in Digitech's revenue cycle management process and ensures that claims are coded and billed accurately and timely. The selected Billing Specialist I will maintain a strong working knowledge of billing rules and regulations for all payor types in the various regions for which they process claims. - Review patient medical records and supporting documentation - Add required data elements to the account in the billing platform, including ICD-9 codes, charges, and billing narratives - Ensure all tasks are completed in accordance with Quick Med Claims policies as well as state and federal guidelines - Meet or exceed defined productivity standards for the position - Properly notate accounts reviewed - Attach necessary documentation within the system or to paper 1500s - Obtain additional information from clients when needed, such as HIPAA forms, pre-authorizations from insurance companies, and physician medical necessity forms, in order to submit third-party claims - Review billing documents in the billing platform using dates provided on patient care reports, physician medical necessity forms, and hospital face sheets - Review and validate claims electronically or on paper - Monitor tags or workflows to ensure timely validation of claims - Process all insurance claim forms in accordance with federal and state laws as well as departmental procedures - Provide accurate billing in compliance with regulatory requirements and internal policies and procedures - Demonstrate biller competency by achieving and maintaining billing accuracy scores that meet or exceed expectations during quality assurance and audit activities - Adhere to all Digitech HIPAA privacy policies and procedures, maintaining the confidentiality and security of sensitive patient information - Additional job duties as assigned Qualifications - High School Diploma or equivalent - 1 – 2 years of Medical billing preferred - Certified Ambulance Coder (CAC) preferred - Demonstrated ability or willingness to attain QMC Biller Certification upon employment - Must be able to type 35 wpm - Basic computer skills including ability to utilize multiple windows and programs simultaneously - Customer service oriented - Attention to detail and focus on quality - Organizational skills - Must display sufficient written and oral communication skills - Must have the ability to work in a fast-paced environment - Must have the ability to work with minimal supervision - Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment Benefits - Competitive salary, commensurate with experience - Comprehensive benefits package, including 401(k) Plan

Title: Billing Specialist, Pharmacy Location: Jacksonville, Florida, USA Work Arrangement: Hybrid Potential Job Type: Full-time Job Description: Extraordinary Care. Extraordinary Careers. With one of the nation’s largest and most innovative long-term care pharmacy services providers, there is no limit to the growth of your career. Guardian Pharmacy of Jacksonville, a member of the Guardian family of pharmacies, has an exciting opportunity for you to join our rapidly growing team in Jacksonville, Florida. Why Guardian Pharmacy of Jacksonville? 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. Schedule: M-F rotating schedule between 10:30 am -7 pm, weekend rotation; Hybrid Potential; Pharmacy in Jacksonville, FL. - During training, the schedule is 9 am-5:30 pm until independence. This would likely last about 90-120 days. - Position will require 1 weekend shift every 3 weeks, rotating. Will work both Saturday and Sunday on their scheduled weekend. The candidate may be asked to cover other varying shifts if a coworker is off on vacation. - Will require a Florida state pharmacy tech license, and Frameworks experience is a plus. Responsible for processing customer bills and insurance claims in an accurate and timely manner. This includes assisting with all daily and month-end billing functions, procedures and reporting. Provides excellent customer service to patients, caregivers, medical providers and insurance carriers. ATTRIBUTES REQUIRED: - Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy - Relational – ability to build relationships with business unit management and become “trusted advisor.” - Strategy and Planning – ability to think ahead, plan and manage time efficiently. - Problem Solving – ability to analyze causes and solve problems at functional level. - Team Oriented – ability to work effectively and collaboratively with all team members. ESSENTIAL JOB FUNCTIONS (include the following): - Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities. Reverify benefit coverage criteria as needed for claims follow up. Accurately enters and/or updates patient/insurance information into billing system. - Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance. Accurately enter patient information into the pharmacy system. - Provide assistance and timely response to all billing customer inquiries via phone or electronic communications. Research and resolve patient billing issues regarding insurance eligibility, coverage, and related benefits. - Provide guidance and support to resident or responsible party by running Medicare plan comparisons during open enrollment and special enrollment periods. Proactively review patient profiles, drug regimens and insurance coverage to evaluate options to save resident money. - Responsible for completion of daily census, admit, discharge, and room changes for the facilities assigned. - Process patient payments, returns, and credits. Transmit individual credit card payments as needed. - May pursue payment from delinquent accounts and make payment arrangements. - Research, identify and organize requested audit documentation in timely manner. - Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed. Make corrections as needed and rebill claims as necessary. - Develop knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances) - Develop proficiency in the utilization of pharmacy information systems to meet operational needs and regulatory requirements. This includes using pharmacy systems to process prior authorizations, resolve rejections, produce various reports as necessary, and complete billing functions. - Rotate through other departments to gain working/functional knowledge of other department workflows. - Follow all applicable government regulations including HIPAA. - Work as a collaborative team member to meet the service goals of the pharmacy. - Other essential functions and duties may be assigned as needed. EDUCATION AND/OR CERTIFICATIONS: - High School Diploma or GED required. - Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required (pharmacy specific). SKILLS AND QUALIFICATIONS: - 1+ years of related experience - Advanced computer skills; pharmacy information system experience preferred. - Ability to work independently and deliver to deadlines. - Great attention to detail and accuracy - Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines - Quality-minded; motivated to seek out errors and inquire about inaccuracies. WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the job. - The noise level in the work environment is usually low to moderate. - Due to the collaborative nature of the business and the need to service customers, the employee must be able to interact effectively with others in an office environment, manage conflict, and handle stressful situations and deadlines. - Requires desk work in office environment. - Ability to work flexible hours. What We Offer: Guardian provides employees with a comprehensive Total Rewards package, supporting our core value of, “Treat others as you would like to be treated.” Compensation & Financial - Competitive pay - 401(k) with company match Family, Health & Insurance Benefits (Full-Time employees working 30+ hours/week only) - Medical, Dental and Vision - Health Savings Accounts and Flexible Spending Accounts - Company-paid Basic Life and Accidental Death & Dismemberment - Company-paid Long-Term Disability and optional Short-Term Disability - Voluntary Employee and Dependent Life, Accident and Critical Illness - Dependent Care Flexible Spending Accounts Wellbeing - Employee Assistance Program (EAP) - Guardian Angels (Employee assistance fund) Time Off - Paid holidays and sick days - Generous vacation benefits based on years of service 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