Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior. Example of Essential Functions: Billing reconciliation of retail pharmacy claims and remittance. Inpatient Pyxis error and other billing error log review and correction. Oncology pharmacy claim denial and monthly audits....
Job Summary
Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior.
Example of Essential Functions:
- Billing reconciliation of retail pharmacy claims and remittance.
- Inpatient Pyxis error and other billing error log review and correction.
- Oncology pharmacy claim denial and monthly audits.
- CDM review, update and validation.
- Monitoring of J-Codes and appropriate IT builds.
- Update of quarterly CMS pricing changes.
- Tracking of pharmacy margin reports.
- Communication with accounts payable and account receivable.
- Focus on drug recovery through Drug Assistant software
Required Knowledge, Skills and Abilities:
- Computer skills (including MS Word, Excel, Powerpoint) are required.
- Excellent communication skills with patients, pharmacists, providers, retail pharmacies and nurses
- Retail pharmacy software and claims adjudication expert
- Basic accounting knowledge.
- Basic knowledge of pharmacy automation.
- Informatics and billing background knowledge preferred.
- Ability to work autonomously once trained.
Minimum Education, Training, and Experience Required:
- High School Diploma/GED is required.
- Experience as pharmacy technician required.
- Registered Maryland Board of Pharmacy Technician required.
- National pharmacy technician certification preferred.
Patient Contact
Must demonstrate and maintain current knowledge and skills in providing appropriate care/contact for patients in the following age groups:
Performance of job does not require patient contact
Physical Demands:.
Light Work - Lifting up to 20 pounds on an infrequent basis (less than one lift every three minutes and/or carrying up to 10 pounds, or requiring walking or standing to a significant degree (about six [6] hours a day).
Ergonomic Risk Factors:
Repetition: Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of the movement, the required force and muscles involved.
Working Conditions:
- Bloodborne Pathogens Exposure Risk: Category B– MAY have exposure to blood or body fluids.
Reporting Relationship:
Reports to Frederick Health Pharmacy Manager