38500 Retail Pharmacy - Pharmacy Business Operations

Full time

Yes

40

M-F 8am-5pm

Pay Range

$21.85 - $32.80

Position Highlights:

• Full-Time; 40 hours/week, Monday-Friday, 8am-5pm
• Pharmacy Business Operations
• On-site at Piedmont Plaza 1 in Winston Salem

Major Responsibilities:

• Reconciles pharmacy claims to third party and interdepartmental payments.  Tracks and reports payments, receivables, and bad debt.  Reviews EOB’s and reconciles bank deposits. 

• Manage documentation and assist in our pharmacy financial assistance program processes.

• Utilizes payer and banking portals to research payment denials and exceptions.  Contacts third party payers to resolve issues resulting in denials/underpayments.  Responds to payer requests for supporting documentation.  
• Communicates payment and remittance information to external billing agencies.  
• Submits manual claims, as necessary.  Monitors claim status to ensure proper payment is received. 
• Ensures that Medicare Part B documentation is completed and maintained to support compliant billing.  Provides billing compliance training for pharmacy staff. 
• Compiles relevant supporting documentation in response to payer audits 
• Manages patient billing and receivables.  Generates patient invoice statements and processes payments.  Administers outpatient pharmacy charity care and extended payment programs.  Answers pharmacy billing phone line and assists patients with questions. 
• Assists with payer credentialing.  Compiles and submits necessary documentation. 
• Submits pharmacy invoices for payment.  Ensures pharmacy is invoiced properly and vendors are paid in a timely fashion. 
• Maintains financial data and generates monthly reports to support month-end accounting entries   
• Produces ad hoc management reports as necessary 
• Seeks ways to minimize waste and reduce cost.  Works within budget guidelines. 

Licensure, Registration, and/or Certification Required:

• Registration or licensure with state board of pharmacy per state of employment requirements.

Education Required:

• High school diploma or equivalent.

Experience Required:

• No work experience required.

Knowledge, Skills & Abilities Required:

• Proficient with calculator, PC, scanner, and copy machine.
• Proficient with Microsoft Excel, Word, and Outlook.
• Proficient with Adobe Pro.
• Ability to multi-task and be self-motivated.
• Strong mathematical skills and the ability to perform accurate detailed work are a must.
• Ability to work in an environment with interruptions and moderate noise levels.

Physical Requirements and Working Conditions:

• Primarily works within an administrative office environment.
• Requires occasional walking, standing, and lifting up to 25 pounds of material.
• May be required to occasionally stretch, bend, twist, squat, and kneel to perform job.
• Must be able to perform manipulative skills such as writing, typing, and data entry into the computer system.
• Must have use of both hands, be able to see clearly, and read small type such as that on some departmental forms and labels.
• Must be able to speak and be understood by others to communicate effectively.
• Must project a professional image and be team oriented.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.