Billing Specialist

AnewHealth is one of the nation’s leading pharmacy care management companies that specializes in caring for people with the most complex, chronic needs—wherever they call home. We enable better outcomes for patients and the healthcare organizations who support them. Established in 2023 through the combination of ExactCare and Tabula Rasa HealthCare, we provide a suite of solutions that includes comprehensive pharmacy services; full-service pharmacy benefit management; and specialized support services for Program of All-Inclusive Care for the Elderly. With over 1,400 team members, we care for more than 100,000 people across all 50 states.

Job Details

CareForwardRx is a newly formed domestic joint venture designed to support and scale pharmacy and medication management services within the Program of All-Inclusive Care for the Elderly (PACE) and managed care ecosystem.

AnewHealth is seeking a Billing Specialist, responsible for supporting the full billing lifecycle for CareForwardRx, ensuring accurate, timely, and compliant revenue processing. This role plays a critical part in maintaining billing integrity across enrollment data, claims activity, and invoicing, and audit support.

As part of a growing and evolving healthcare organization, the Billing Specialist contributes to maintaining a scalable billing infrastructure, strengthening internal controls, and supporting cross-functional coordination with operations team, pharmacy network partners, and finance leadership.

This role is ideal for a billing professional who thrives in a fast-paced, service-driven environment and is comfortable operating both hands-on and collaboratively to support operational excellence.

Responsibilities

Billing Lifecycle Management

• Execute monthly billing processes, including enrollment and disenrollment updates, data validation, and invoice preparation.

• Review and reconcile client census counts and supporting billing inputs to ensure completeness and accuracy.

• Generate and distribute invoices in accordance with contractual terms and internal controls.

• Review vendor-related charges (e.g., courier invoices) and ensure appropriate client billing allocation.

Claims Resolution & Operational Coordination

• Support resolution of pharmacy billing issues, including rebills, claim rejections, and insurance discrepancies.

• Partner with operational teams and network pharmacies to investigate and resolve PBM and billing issues.

• Process and document billing adjustments, including medication return credits.

Compliance, Audit & Process Support

• Prepare billing schedules and documentation to support internal reviews and external audits.

• Assist with onboarding new clients or transitions of services to ensure billing continuity.

• Assist with audits, including annual PACE audits, quarterly PBM audits, and other internal or external reviews

The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job.  Not all of the duties may be assigned to a position.

Qualifications: These represent the desired qualifications of the ideal candidate. They are not meant to limit consideration for candidates who do not meet all of the standards listed. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education

• High School diploma or equivalent required.

Experience

• 2+ years of experience in healthcare billing, pharmacy operations, revenue cycle, or related financial operations required.

• Experience supporting PACE programs or PBM billing preferred.

Skills & Abilities

• Strong understanding of billing operations and revenue cycle workflows.

• Excellent analytical and problem-solving skills with high attention to detail.

• Strong organizational and time management skills; able to manage multiple priorities in a deadline-driven environment.

• Effective verbal and written communication skills; able to collaborate cross-functionally and communicate clearly with operational stakeholders.

• High degree of ownership, accountability, and follow-through.

• Proficiency in Excel and comfort working across multiple systems and billing platforms.

• Ability to operate independently while contributing collaboratively in a dynamic environment.

Schedule:  This is a full-time position with an expectation to work an average of 40 hours per week and be available outside of normal business hours to meet customer expectations on an ad-hoc basis. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

AnewHealth offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.

AnewHealth provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants are encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.